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Can Trazodone Be Discontinued Without Side-effects?

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Posted on Mon, 6 Nov 2017
Question: I am taking 50 mgs trazodone and 150 mg gabapentin and .25 mg klonopin at night to help with sleep issues on Parnate. I feel like the trazodone is helping with some of the emotional blunting from the Parnate, but adding to irritability and agitation a little later in the day.

I was considering switching from trazodone to 5-10 mgs of Doxepin or 20 mgs or nortriptyline for sleep. I know these are technically contraindicated for MAOI but in practice are used safely at low doses.

My question is, having taken 50 mgs of trazodone for 3 months, can I stop immediately without side effects? The one day that I tried to do doxepin instead I didn't sleep well and had lots of cognitive/sedating effects the next day. I thought maybe it was a result of skipping trazodone rather than the doxepin itself.

Thank you
doctor
Answered by Dr. Alexander H. Sheppe (18 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I would absolutely NOT use doxepin or nortriptyline at any dose. They cannot be used safely at any dose with Parnate -- you run the severe risk of potentially fatal serotonin syndrome. This is absolutely not safe and no competent doctor would prescribe this combination.

Trazodone is extremely unlikely to be causing irritability or agitation at 150mg. I would stick with it, as it is likely helping considerably with sleep. If you do decide to stop it, you do not need to taper it, as it is at a low dose and does not have withdrawal.

Please rate and close your answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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Can Trazodone Be Discontinued Without Side-effects?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. I would absolutely NOT use doxepin or nortriptyline at any dose. They cannot be used safely at any dose with Parnate -- you run the severe risk of potentially fatal serotonin syndrome. This is absolutely not safe and no competent doctor would prescribe this combination. Trazodone is extremely unlikely to be causing irritability or agitation at 150mg. I would stick with it, as it is likely helping considerably with sleep. If you do decide to stop it, you do not need to taper it, as it is at a low dose and does not have withdrawal. Please rate and close your answer when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers