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Question:

After my mother had a stroke, she was given an antidepressant as a sleeping pill. I think it started with "tr."

Can you tell me what it might have been and why an antidepressant might be prescribed for insomnia?

Answered by: Gregory Sullivan

Trazodone (brand name Desyrel) is an older antidepressant, developed in the 1960s, which was one of the popular antidepressants before the advent of the serotonin selective reuptake inhibitors. Its typical dose, when used for depression, was 300-600 mg a day. It was FDA-approved for use in depression in the U.S. in 1982; and it had the advantage over another class popular at that time, the tricyclic antidepressants, in that it was not lethal in overdose.

The problem with it, though, was its more prominent side effect: sedation. It is now common for physicians to take advantage of the sedation side effect when prescribing it instead as a sleep aid. Typically when used for this "off-label" use, the dose is much lower - in the range of 50-150 mg once a day, about an hour before bed. For some, it is a wonderful sleep aid, and it has the advantage over many other sleep aids in not being habit forming for individuals at risk for addictions. For others, it is too long lasting, with the sedating effects lasting for many hours after the desired wake up time.