The recommended maximum tolerated doses of trazodone for elderly patients for the treatment of depression are 300 to 400 mg/day. The pharmacokinetics of trazodone have been shown to be dependent on age, primarily due to decreased oxidative metabolism in older patients.
These medications are discouraged for insomnia in older adults because of their strong anticholinergic properties and the increased risk of confusion , dry mouth, and constipation. Sedating antidepressants, such as trazodone , mirtazapine, and doxepin, are often prescribed for insomnia.
In the elderly, nonbenzodiazepines such as zolpidem , eszopiclone , zaleplon , and ramelteon are safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines . Pharmacotherapy should be recommended only after sleep hygiene is addressed, however.
Drugs you should not use with trazodone Examples of these drugs include: Monoamine oxidase inhibitors ( MAOIs ), such as isocarboxazid , phenelzine , tranylcypromine, or selegiline. You shouldn’t take trazodone with MAOIs or within 14 days of taking them. Taking these drugs together raises your risk for serotonin syndrome.
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines , another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
Sleep in a dark, quiet, cool room (between 60 and 67 degrees Fahrenheit). Before bed, take a warm bath or practice relaxation techniques such as meditation or breathing exercises. If you can’t fall asleep after 20 minutes, get up, go to another room, and do a relaxing activity like listening to calming music.
Your doctor may advise you to take your dose of trazodone once a day. If your dose is 300mg a day or less, your doctor will probably tell you to take it as a single dose at bedtime. As trazodone can make you feel sleepy, taking it at bedtime may help if you’re having trouble sleeping.
We found that the incidence of dementia among patients taking trazodone was higher than that in patients taking other antidepressants.
Trazodone produced small but significant impairments of short-term memory , verbal learning, equilibrium, and arm muscle endurance across time points.
Tips to Sleep Tight Take a warm bath. When you get out of the tub, the drop in body temperature may help you feel tired. Take time to calm down before you turn out the lights. Make the bedroom a sleep zone. Avoid afternoon naps. Don’t drink alcohol close to bedtime.
Although melatonin is usually considered safer than benzodiazepines, an increased fracture risk has recently been reported with this drug, and caution should be advised for elderly patients at risk for falls. Melatonin is only one option in the armamentarium of sleep solutions for older adults.
If you require a little extra help to get a good night’s sleep, consider trying the following 9 natural sleep-promoting supplements. Melatonin . Melatonin is a hormone that your body produces naturally, and it signals to your brain that it’s time to sleep ( 7 ). Valerian root . Magnesium . Lavender . Passionflower . Glycine.
Because there’s so little supporting evidence, treatment guidelines by AASM don’t recommend trazodone for the treatment of chronic insomnia . Still, trazodone may improve insomnia symptoms initially, as found in one small study, but this effect could fade after a few weeks. Insomnia with depression.
The 3 to 6 hour half-life of trazodone makes it most suitable for treating sleep onset insomnia or maintenance insomnia .
Patients who take the drug for a sleep disorder can experience the sedative effects within 30 minutes, depending on the type used. Patients who take the drug as an antidepressant may not notice symptom relief for one to two weeks , and it may take up to four weeks to experience the full benefits.