Agree that is effective for insomnia. Especially insomnia where sleep initiation is good and the main issue is awakening at 3-4 am and having trouble shutting of your thoughts and trying to go back to sleep.

50 mg is generally enough
H
Good for Diabetic neuropathy. Generally dose for that is 50 to 100 mg. Works well enough I’m most cases ( as neuropathy is a much bigger issue at night) to not require Gabapentin.

Aside from some patients being intolerant, it is good for this issue.

Gabapentin, less so. One main reason is Neuropathy pain is generally a night time issue. Taking a Med all day for this is mostly doing nothing.

Trazodone is highly effective in treating insomnia especially when people take 50 to 150 mg right at bedtime. It has been proven time and time again it is an inexpensive and very effective medication for insomnia. But the drug companies want to make you believe that you need to take one of those horrible drugs that does not allow you to dream unlike trazodone where are you dream on it and it is not addictive. Most other insomnia medication’s are extremely dangerous and cause cognitive impairment unlike trazodone stop dismissing trazodone

Perfectly stated. Also appreciate SteveT’s notation of who funded the study. As others have, I’ve only ever prescribed trazodone for insomnia and it is much preferable to the hypnotics. Best avoided in folks over 65, however, if possible, Beers List and all that.

In tiny print near the end, the paper reveals that Idorsia Pharma funded the study. One of their products is an insomnia drug, Quviviq. This study is VERY handy for their drug reps to use when their target says "Oh, I just use trazodone for insomnia...", and probably cost less than $10K to pay for some research assistant time. Since Quviviq costs about $500 for a month prescription, this 'investment' makes money after only 20 prescriptions.

Just need to watch the QT interval. Would be a shame to risk VT while treating insomnia

Interesting that the authors purposely excluded peer reviewed articles that support trazadone's efficacy and safety for insomnia:

https://www.ncbi.nlm.nih.go...

YEP...would love to see trazodone compared long term to Lunesta or Ambien. I hear more side effects from the later two.

interesting thought experiment - compare this use widespread use of trazodone off label to the ability of doctors to prescribe hydorxychloroquine and/or ivermectin off label for covid. why is it okay for one but not the other?

Probably because of the million people who died of one of those two conditions. Also the complete lack of efficacy of two of the three medicines.

i have only seen trazodone used as a sleep aid in the 10 years i've worked inpatient psychiatry. i have never seen it used as an antidepressant.

Because at the higher dosing the sedation is overwhelming. In 31 years of FP I have never used it for anything but insomnia.

In 30 years of IP/OP multi specialty transcription and then coding, I can count on one hand the times I’ve seen trazodone used as a primary rx for depression.