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Does Trazodone Have Any Effect On QT Interval?

Posted on Wed, 18 May 2016

Question: Dr. Sharka,

I might try some medication to help with sleep, Trazodone more specifically. Should I be concerned about taking this medication in regards to QT interval? Please see your comments from prior thread below...

"Your QTc duration doesn't show any implications on actual complains.

Detailed Answer:

Hello dear XXXXX!

Welcome and thank you for asking on HCM! Sorry for the delayed response (because of my unexpected professional commitment during weekend).

I reviewed carefully your uploaded ECG report, as well as our previous discussions (with respective uploaded cardiac ultrasounds).

I would prefer better to review by myself the direct ECG recordings; nevertheless I would to explain that your uploaded ECG reports don't show evidence of any abnormalities (no rhythm or conductance disorders, no specific ischemic changes).

There is a rather borderline QTc prolongation, but nothing to worry about, as you haven't any obvious triggering factors for generating any cardiac arrhythmia.

Your QTc value doesn't explain your actual complains (fatigue after exertion, etc).

A very prolonged QTC could be a clear predisposition for cardiac ventricular arrhythmia.

But this is not your case. So, relax!

Meanwhile, I would recommend checking your resting ECG periodically to be alert for any changes.

Regarding your complains, as I have advised you before, I would recommend to check your pulmonary function test and an arterial blood gas analysis, confirming or excluding such way any possible pulmonary implications on post-exertion fatigue.

You should also check your thyroid and adrenal functions (by dosing respective hormone levels), as they may have adverse intrusions regarding this issue (if confirmed abnormal).

If you have any other uncertainties, feel free to discuss with me!

Hope to have been helpful! Greetings! Dr. Iliri"

As always thank you for your professional input.
XXXXXXX

Answered by Dr. Ilir Sharka (47 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again, dear XXXXXXX

I understand your concern and would like to explain that regarding a potential effect in triggering QTc interval prolongation, Trazodone may rarely exert a mild effect in QTc prolongation; and this may happen mainly in overdoses of Trazodone.

So, in clinical studies Trazodone has generally showed a safe profile regarding influences on QTc interval.

Meanwhile, in studies of selective monoamine reuptake inhibitors (SSRIs, venlafaxine, duloxetine, reboxetine), therapeutic doses of these drugs were not found to have any effect on the QTc interval.

It will depend on your doctor’s decision the selection of the right therapeutic strategy.

If really indicated by your doctor, Trazodone may be used carefully without any fear for adverse ECG implications.

Nevertheless, it is necessary to check your ECG periodically when using psychotropic drugs.

Hope to have been helpful!

I remain at your disposal for further discussions if necessary.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar