Major depressive disorder is one of the most common mental health disorders in the United States. In 2014, almost 7 percent of American adults (aged 18 and older) suffered from a major depressive episode, the National Institute of Mental Health (NIMH) publishes. Trazodone is one of the many medications that is available to treat major depression.
Marketed both in generic form and under the brand name Oleptro, trazodone is an antidepressant drug that is also prescribed for anxiety, schizophrenia, and insomnia at times. Trazodone works on serotonin levels in the body by selectively blocking certain serotonin receptors in the brain and thereby increasing the levels of the neurotransmitter in a person’s system at one time. Serotonin is one of the brain’s chemical messengers that signals feelings of pleasure. When someone is depressed, serotonin levels may be low; by increasing these levels with a drug like trazodone, people may feel happier.
Drugs that act on the brain’s natural pleasure-inducing chemicals may be a target for abuse, potentially even more so for individuals who may suffer from a deficiency in these chemicals already. Drugs may become a form of self-medication for depressive or anxiety symptoms for some people. The Anxiety and Depression Association of America (ADAA) reports that 20 percent of Americans who suffer from a mood or anxiety disorder will also battle a substance use disorder in their lifetime and vice versa.
Understanding Trazodone Abuse
NIMH reports that brain chemistry, genetics, and environmental factors such as stress can contribute to depression, and the same factors may play a role in substance abuse. Prescription drug abuse is extremely common in the United States, as the National Institute on Drug Abuse (NIDA) estimates that over 50 million Americans (over the age of 12) have used a prescription drug for a nonmedical reason at least once in their lives. According to the 2013 National Survey on Drug Use and Health (NSDUH), more than half of the time, these drugs are obtained for free from a friend or relative. People may feel that they are “safer” than other illegal drugs since they were initially prescribed by a doctor. Prescription medications may be crushed to be snorted, smoked, or injected; chewed; or ingested orally without a legitimate prescription. Taking trazodone in any way other than as prescribed is considered abuse.
Trazodone may not produce the same kind of “high” that recreational use of other drugs may; however, it can cause a kind of mania. It may also produce anxiety, restlessness, tremors, a skin rash, panic attacks, chest pain, priapism (erections lasting longer than six hours), increased depression, or seizures when used or abused. It may be commonly mixed with other substances, such as alcohol or other medications, to amplify the effects of these substances as well.
Abuse of the drug is a dangerous practice and can increase the risk for suffering an adverse reaction that may result in a toxic overdose. The Drug Abuse Warning Network (DAWN) of 2011 published that close to 90,000 individuals sought emergency department (ED) treatment for a negative reaction to the nonmedical use of an antidepressant medication that year. Someone abusing trazodone may appear drowsy, have impaired judgment and make questionable decisions, be less coordinated physically, and not able to focus or concentrate cognitively. Mood swings, dizziness, headaches, constipation, nausea, muscle weakness, confusion, sweating, and blurred vision are also typical side effects of trazodone use.
Another possible side effect of abusing trazodone is the potential for hallucinogenic effects. Some people have reported auditory hallucinations when taking trazodone, or hearing things that aren’t actually there. The medication guide for Oleptro, as published by the U.S. Food and Drug Administration (FDA), reports suicidal thoughts and actions as possible side effects of the drug as well.
Getting Help for Trazodone Misuse
When a person abuses a drug like trazodone, the brain’s natural chemistry is disrupted. If this is perpetuated, a dependence on the drug can be created over time. Drug dependence occurs when the brain needs trazodone to keep working the same way. If the drug use is stopped, withdrawal symptoms may occur. The journal Pharmacy & Therapeutics reports that trazodone withdrawal symptoms include anxiety, agitation, and difficulties sleeping. In order to avoid these side effects, the drug should not be stopped suddenly. Instead, the dosage should be tapered, or lowered, slowly over a period of time.
During medical detox, trazodone can be slowly weaned from the body. Medical detox takes place in a specialized facility that provides medical and mental health supervision and care 24 hours a day, seven days a week. During the detox process, trained professionals may use other medications to manage potential drug cravings, withdrawal side effects, or mental health concerns as well.
Trazodone can have potentially life-threatening interactions when mixed with other types of antidepressants that also act on serotonin levels, however. Serotonin syndrome can cause hallucinations, irregular heart rate, hypertension, incontrollable physical movements, hyperthermia, vomiting, diarrhea, mental decline, muscle rigidity, coma, or even death. As a result, medical, mental health, and substance abuse treatment providers all need to work together during trazodone detox and treatment to avoid negative pharmaceutical interactions.
Different people may have different levels of dependence on trazodone and require varying levels of care. Certain people may have more severe addictions, such as those who abuse trazodone in large amounts, those who abuse the drug in conjunction with other substances, those with underlying medical or mental health issues, those who have taken the drug for a long time, and those with a family history of substance abuse and/or addiction.
There are many factors that may be involved in why a person may abuse trazodone in the first place, from environmental triggers, to biological or genetic ones, to emotional factors. Understanding what may have led an individual to abuse a drug like trazodone can help with learning how to manage potential stressors, defining an effective treatment plan, and creating an environment that is supportive of recovery. Treatment programs for trazodone abuse range from outpatient models that are flexible and can be scheduled around a person’s life obligations, to residential care that is more structured and comprehensive.
Therapy and counseling are important aspects of any substance abuse treatment program, as are support groups and educational opportunities. Treatment for substance abuse, dependence, and addiction is highly individual. A complete evaluation and assessment can help individuals decide on the right level of care to enhance a long and healthy recovery.