What Causes Extreme Sadness And Irritability After Taking Trazodone?

Posted on Mon, 4 Sep 2017

Question: Since adding Trazodone (50 mg) for sleep to my Parnate 30 mg and Lamictal 100mg regimen I have been noticing a gradual return to depression and irritability, especially mid-day. Today was the worst I had feelings of sadness and despair combined with extreme irritability starting around 11 am.

I also take .25 mg klonopin at night to improve sleep and up to .25 mg as needed during the day. Although I wasn't feeling anxious I took .25mg klonopin, and both the dysphoric feeling and irritability lessened in 30 mins.

Knowing the klonopin inhibits the activity at different receptors, I'm wondering if this improvement is just a "feel good" effect from the klonopin (which I shouldn't pursue); or, more importantly, is it blocking a negative reaction from one of my medications that was making me feel bad?

I know trazodone has antagonizing effects at the 5ht1 and 2 receptors, but that it's metabolite has completely different effects that may be uncomfortable.

Thanks

Answered by Dr. Seikhoo Bishnoi (47 minutes later)

Brief Answer:
Trazodone might result in worsening of mood.

Detailed Answer:
Hello thanks for asking from HealthcareMagic,

I can understand your concern.

Trazodone at 50 mg is not an antidepressant but is used for sleep only. If the drug has been started recently then yes this could worsen the symptoms of depression. In most individuals, this causes mood disturbances, dysphoria or even anxiety too. This worsening of mood is self-limiting and will go by own.

You got relief from Klonopin because the drug reduced anxiety and it resulted in subjective improvement. Also even though Klonopin is a benzodiazepine drug and is used mainly for sleep and anxiety but the drug has direct antidepressant actions too. This has been shown in some studies too. So we can attribute this action for improvement of mood after taking Klonopin.

So please wait for few more days and you will get adjusted to the dose of Trazodone. For worsening of symptoms you can use Klonopin on as needed for some time.

Thanks and Take care

Please let me know if you need more assistance.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee