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Antidepressants, including trazodone, are prescribed for treating depression and other mental health disorders. While they can offer significant benefits, they also come with potential risks, especially for younger individuals. It is crucial to discuss these risks and benefits with a healthcare provider, particularly for those under 25 years old. Here are important safety considerations and warnings regarding the use of trazodone:

• Worsening Depression and Suicidal Thoughts: Antidepressants may sometimes exacerbate depression or increase suicidal thoughts, particularly in individuals 24 years old or younger. This risk is heightened in the initial months of treatment and during dosage changes. Immediate medical attention is necessary if symptoms such as suicidal thoughts, anxiety, panic attacks, irritability, or restlessness occur.

• Serotonin Syndrome Risk: Trazodone can lead to a rare but severe condition called serotonin syndrome, especially when used with other medications that increase serotonin levels. Symptoms include fast heart rate, sweating, muscle stiffness, fever, and confusion. Seek emergency medical help if these symptoms arise.

• Heart Rhythm Concerns (QT Prolongation): Trazodone may cause life-threatening heart rhythm issues, known as QT prolongation. Risk factors include electrolyte imbalances, existing heart conditions, or concurrent use of other heart-affecting medications. Regular heart monitoring may be necessary, and emergency help should be sought if symptoms like chest pain or fainting occur.

• Cognitive Impairment and Drowsiness: This medication may cause significant drowsiness or impair cognitive function. Avoid activities requiring alertness until you know how trazodone affects you. Consult your healthcare provider if excessive sleepiness persists.

• Hypotension and Dizziness: Trazodone may cause low blood pressure, leading to dizziness or fainting. Rise slowly from sitting or lying positions to mitigate this risk, and consult a healthcare professional if dizziness continues.

• Increased Bleeding Risk: The risk of severe bleeding may rise if trazodone is taken with blood-thinning medications. Be alert for unusual bleeding or bruising and seek medical advice if necessary.

• Prolonged Erection (Priapism): Rarely, trazodone can cause prolonged and painful erections. Seek immediate medical attention if an erection lasts longer than four hours.

• Glaucoma Risk: Trazodone may trigger or worsen angle-closure glaucoma. Regular eye examinations are recommended, and any vision changes should be reported to a healthcare provider.

• Hyponatremia (Low Sodium Levels): This medication may cause low sodium levels in the blood. Symptoms such as confusion, headache, or difficulty concentrating require urgent medical evaluation.

• Withdrawal Symptoms: Do not abruptly discontinue trazodone without consulting a healthcare provider, as withdrawal symptoms like anxiety or seizures may occur. A gradual dose reduction is recommended.

Contraindications:

• Avoid trazodone if you are currently taking or have recently taken MAOIs, linezolid, or methylene blue within the last 14 days, as serious health risks may ensue.

Always inform your healthcare provider about any other medications you are taking to avoid potential interactions.

Common side effects:

• Sleepiness
• Dry mouth
• Dizziness
• Headache
• Blurred vision
• Nausea or vomiting

Less common but important to monitor:

• Constipation
• Fainting
• Fatigue
• Nervousness
• Confusion
• Changes in blood pressure
• Changes in weight

Serious side effects:

• Suicidal thoughts
• Serotonin syndrome
• Abnormal heart rhythms
• Severe bleeding
• Low blood sodium levels
• Painful or prolonged erection
• Severe allergic reactions
• Vision changes

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Drugs affecting trazodone metabolism (e.g., azole antifungals, HIV protease inhibitors, macrolide antibiotics)
• Serotonin-enhancing drugs (e.g., SSRIs, SNRIs, St. John's wort, MDMA)

Interactions with low risk that usually do not require a change in therapy:

• Sedatives and alcohol
• Digoxin
• Phenytoin