Desyrel

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Desyrel (trazodone) is an antidepressant used to treat depression, and has a secondary effect of treating anxiety, insomnia, and other psychiatric conditions when present in relation to depression. It is meant for use in patients ages 16 and up. Elderly patients may need lower doses.

The medication is believed to work by increasing the levels of serotonin in the brain, though the exact mechanism by which this, or any, antidepressant works is unclear.

Taking Desyrel

Desyrel is administered by tablet, once or twice per day. Tablets should be taken with food to prevent dizziness and enhance absorption. It is normal for dosage to start small and be gradually titrated upwards until an effective dose is found, and vice versa at the end of treatment.

Treatment may be modified according to other personal variables, such as age, weight, other medical conditions, other medications being taken, and so forth. In general, however, treatment roughly follows:

  • Patients are typically started on 150 mg per day, taken in one dose or divided into two smaller doses.
  • Every 3 to 7 days dosage may be increased in 50 mg increments, if necessary.
  • Do not exceed 400 mg for outpatients, 600 for inpatients.

It usually takes 2 to 4 weeks of treatment with Desyrel for full benefit to be felt. Treatment may continue for as long as needed, usually several months. After the depression begins to drop treatment may also begin to taper off. This should not be done without the involvement of a doctor.

Patients taking Desyrel report feeling:

  • More stabilized mood
  • Fewer and milder mood swings
  • Improved focus and control of thoughts
  • Less anxiety
  • More interest in activities
  • Improved impulse control

Patients taking a single daily dose may want to take the medication before bed, as it can cause drowsiness. Likewise if taking a divided dose taking the larger of the two halves at bedtime may help.

If a dose is forgotten, take it as soon as remembered unless it is within 12 hours of the next dose, in which case it can be skipped entirely.

Potential Complications

Desyrel is not the ideal medication for everyone. Patients who have a history of the following should discuss risks and warning signs with a doctor before use:

  • Kidney or liver disease
  • Bleeding problems
  • Heart rhythm problems
  • Low blood pressure
  • Glaucoma
  • Heart disease
  • Bipolar disorder

The medication is known to cause certain side effects. Most are mild and not cause for concern, and will often stop occurring as the body adjusts to treatment. Less commonly more serious side effects may develop, which warrant medical attention:

  • Confusion
  • Fast, pounding, or uneven heartbeat
  • Insomnia
  • Painful and/or prolonged erection of the penis
  • Unusual bleeding or bruising
  • Hallucinations
  • Muscle spasms

Desyrel can interact with a range of other medications; of most concern are MAOIs, tramadol, tryptophan, St. John's wort, lithium, fentanyl, buspirone, ritonavir, indinavir, phenytoin, digoxin, carbamazepine, medications to treat fungal infections, diuretics, blood pressure medications, blood thinners, NSAID painkillers, triptan medications, and other antidepressants. Check with a doctor or pharmacist before mixing other medications with Desyrel.

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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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