Medication guide

Trazodone (Desyrel / Reslin)

What is trazodone?

Trazodone is sold in Japan as Desyrel or Reslin (デジレル／レスリン on Japanese packaging; two brands, same medicine), and in the UK as Molipaxin; in the US it's prescribed simply as trazodone. It's an older serotonin-acting antidepressant that is distinctly calming rather than activating, and because it makes most people sleepy, doctors often use it at a low evening dose when poor sleep is a big part of the picture.

How is it different from other antidepressants?

Calming rather than activating: it helps the sleep side of depression from the first nights
A non-habit-forming way to support sleep, which is why doctors often prefer it over sleeping pills
Flexible: works at low doses for sleep-heavy pictures, higher doses for mood
Pairs well: often used alongside another antidepressant that handles the daytime

What is it used for in Japan?

Depression.

How does it help?

It supports serotonin signalling while quieting the overalertness that keeps many depressed people awake at night. Sleep often improves within days; the effect on mood builds more gradually over weeks. If you don't feel better right away, that's normal; keep taking it as prescribed.

What should I tell my doctor before starting?

Trazodone suits most people, and only one situation rules it out entirely:

A past allergic reaction to trazodone

And tell your doctor first if any of these apply; these usually just need adjustments or a closer eye:

Other antidepressants, tramadol (a painkiller), migraine triptans, or lithium
Blood pressure medicines: trazodone can add to their effect and cause lightheadedness
A heart rhythm problem
Blood thinners, or regular painkillers like ibuprofen
Other sedating medicines, or regular alcohol use
St John's Wort supplements
Pregnant, planning to be, or breastfeeding (see the section below)

How do I take it, and what if I miss a dose?

Trazodone is usually taken in the evening, at a dose set by what it's doing for you (low for sleep-heavy pictures, higher for mood).

If you miss a dose: just skip it if the next one is close. Never take a double dose to catch up
The first nights may bring morning heaviness; if it lingers, tell your doctor; timing and dose can be adjusted
Go easy on alcohol; it stacks with the drowsiness

What side effects should I expect?

Most are mild and settle within the first week or two as your body adjusts, and many can be eased with a counter-medicine (for nausea, for example). Not everyone gets them.

Drowsiness: expected, and usually the reason it's prescribed at night
Feeling lightheaded when standing up: get up slowly, especially at night
Dry mouth
Constipation
Nausea

If anything is bothering you, tell your doctor; there's often a way to adjust. And if you ever feel worse instead of better, tell us straight away; it's easily managed, and that's what we're here for.

Finally, one thing that is rare (most people never experience it) but good to know:

For men: an erection that persists for hours without stimulation isn't safe to wait out; stop the medicine and get medical care the same day, and it's treatable

Will I become dependent? How do I stop safely?

No; trazodone isn't addictive, which is part of why doctors like it for sleep. There's no craving, no tolerance creep, and stopping is usually straightforward. Still, don't stop suddenly on your own; any change is planned with your doctor so the sleep and mood gains hold.

Can I drive while taking it?

The Japanese label advises against driving while taking it. Trazodone's drowsiness is the point at night, but it can carry into the day, and the prescribing information here instructs that patients on it shouldn't drive or operate dangerous machinery. If morning carry-over keeps happening, tell your doctor; dose and timing can be adjusted.

What about pregnancy and breastfeeding?

Tell your doctor early; this is decided case by case. Neither pregnancy nor breastfeeding is an automatic reason to stop, and if trazodone is mainly supporting sleep, the plan sometimes shifts to other approaches during pregnancy. Don't stop or continue on your own. Our guides to medication in pregnancy and medication while breastfeeding cover the details.