Desyrel (trazodone): uses, side effects, and what to expect

If you've been prescribed trazodone or are wondering whether it could help with your symptoms, you're in the right place. Desyrel (trazodone) is a serotonin antagonist and reuptake inhibitor, or SARI, used to treat depression and commonly prescribed for sleep and anxiety.

Key takeaways

• Desyrel (trazodone) is a SARI antidepressant approved to treat depression and commonly prescribed for insomnia and anxiety.
• Trazodone works by increasing serotonin activity in the brain and blocking receptors that promote wakefulness.
• It may take two weeks or longer to feel the full antidepressant benefit, though sedating effects often begin sooner.
• Trazodone is not a controlled substance and is not considered habit-forming.

What is Desyrel?

Desyrel is a brand name for trazodone, a medication in the SARI (serotonin antagonist and reuptake inhibitor) class. It is also sold under the brand name Oleptro. Trazodone is sometimes called an atypical antidepressant because it works differently from SSRIs and SNRIs. It is FDA-approved for the treatment of depression and widely prescribed for insomnia and anxiety as well.¹

What does Desyrel treat?

Trazodone is prescribed for several conditions. Here is what it is approved for and what it is used for outside of its original approval.

On-label uses

• Depression (major depressive disorder)¹

Off-label uses

Psychiatrists sometimes prescribe medications off-label, meaning for a condition the FDA has not specifically approved the drug to treat. Off-label use is common, legal, and based on clinical evidence.

• Insomnia (trazodone is one of the most commonly prescribed medications for sleep at low doses)²
• Anxiety disorders
• Agitation in dementia

How does Desyrel work?

Trazodone affects serotonin, a chemical messenger in the brain involved in mood and sleep regulation. It increases serotonin availability while also blocking certain receptors that promote wakefulness. This dual action is why trazodone can help with both depression and sleep problems.¹

• Boosts serotonin activity. Trazodone increases serotonin levels in the brain, which plays a key role in mood and sleep regulation.¹
• Has a sedating effect. Trazodone blocks certain receptors that promote wakefulness, which helps with sleep.¹
• Supports mood and sleep. By influencing both mood and sleep pathways, it can help with depression and insomnia.¹

3 things a Talkiatry psychiatrist wants you to know about Desyrel

• It's commonly used off-label for sleep. While approved for depression, trazodone is most often prescribed at low doses to help with insomnia. If sleep is a major concern, your psychiatrist may consider trazodone as part of your treatment plan.
• It can cause grogginess. Some people feel groggy or drowsy the morning after taking trazodone, especially at higher doses. Taking it earlier in the evening or adjusting the timing with your psychiatrist can sometimes help.
• Don't stop suddenly. If you've been taking trazodone regularly, it should be tapered gradually under medical supervision. Stopping abruptly can cause withdrawal-like symptoms.

Common side effects of Desyrel

Most medications come with the possibility of side effects. With trazodone, some of the more commonly reported ones include:¹

• Drowsiness or tiredness
• Diarrhea
• Changes in appetite or weight
• Nasal congestion
• Sexual difficulties, including reduced sex drive or difficulty with arousal or orgasm
• Swelling of the hands, feet, or legs

Talk to your psychiatrist if any of these feel persistent, severe, or get in the way of your day.

Serious side effects of Desyrel and when to seek help

Serious side effects are less common but important to know about. Contact your psychiatrist or seek emergency care if you notice any of the following:¹

• New or worsening depression, thoughts of self-harm, panic attacks, extreme worry, or agitation
• Chest pain, shortness of breath, dizziness, or fainting
• Fast, pounding, or irregular heartbeat
• Loss of consciousness
• Fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness (these may be signs of serotonin syndrome)
• Seizures
• Unusual bruising or bleeding
• A prolonged erection lasting longer than 6 hours (priapism), which requires immediate medical attention
• Eye pain, nausea, changes in vision such as seeing colored rings around lights, or swelling or redness in or around the eye

Call your psychiatrist right away or seek emergency care if you experience any of these symptoms.

What to watch for when starting Desyrel

When you first start taking trazodone, there are a few things to keep in mind:¹

• It may take two weeks or longer to feel the full benefit for depression. Sedating effects for sleep may begin sooner.
• Trazodone can cause drowsiness and may affect judgment, thinking, and coordination. Avoid driving or operating machinery until you know how it affects you.
• It may cause dizziness or lightheadedness when standing up too quickly. Get out of bed slowly and rest your feet on the floor before standing.
• Avoid or limit alcohol, as it can worsen drowsiness and other side effects.
• Your psychiatrist may start with a low dose and increase it gradually.

What to do if you miss a dose of Desyrel

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.¹

Who should talk to a psychiatrist before taking Desyrel

Some health conditions, medications, and life situations change how Desyrel is prescribed. Tell your psychiatrist if any of the following apply to you:¹

• You have a known allergy to trazodone or any of its inactive ingredients
• You are currently taking or recently stopped taking a monoamine oxidase (MAO) inhibitor
• You have a personal or family history of long QT syndrome, or a history of heart attack
• You have heart, liver, or kidney disease
• You have bleeding problems
• You have sickle cell anemia, multiple myeloma, leukemia, or conditions affecting the shape of the penis
• You are pregnant, planning to become pregnant, or breastfeeding
• You have a history of heavy alcohol use or substance misuse