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Trazodone
genericTrazodone hydrochloride — FDA-approved for major depressive disorder; widely used off-label for insomnia
$4 - $15/month
/month
Dosing
25mg to 100mg taken at bedtime for insomnia. Providers typically start at a low dose (25-50mg) and adjust based on response. Should be taken shortly before bed, as sedation typically begins within 30-60 minutes.
Type
Generic
Key Fact
Trazodone is one of the most commonly prescribed medications for insomnia in the United States, despite this being an off-label use. It is not classified as a controlled substance, which makes it easier to prescribe and refill through telehealth platforms.
Price
$4 - $15/month
Trazodone is an antidepressant that, at lower doses, is widely used off-label as a sleep aid. Its sedating properties make it one of the most commonly prescribed medications for insomnia in the US, and its non-controlled status means it can be readily prescribed through telehealth platforms without the regulatory hurdles associated with benzodiazepines or Z-drugs like Ambien. While trazodone is not FDA-approved specifically for insomnia, decades of clinical use and a growing body of research suggest it may help many patients fall asleep and stay asleep. It is worth noting, however, that evidence for its insomnia use is not as robust as for some FDA-approved sleep medications.
Where to Get Trazodone
Compare providers offering trazodone — ranked by our editorial team
Cerebral
Prescribed as part of Cerebral's medication management plan. Insurance accepted and may reduce cost significantly.
$60/mo (includes prescriber visit)
/month
Brightside Health
Available through Brightside's psychiatry plan with measurement-based tracking of sleep outcomes.
$95/mo (includes prescriber visit)
/month
Hims
Available through the mental health medication management plan. Prescription sent to pharmacy.
$49/mo (includes prescriber visit)
/month
PlushCare
Board-certified doctor consultation with prescription sent to your local pharmacy. Trazodone generic is approximately $4-$15 at most pharmacies.
$30 copay or $129/visit + medication cost
/month
Sesame Care
Affordable one-off consultations with prescription sent to your preferred pharmacy.
From $34/visit + medication cost
/month
How Trazodone Works
Trazodone works primarily by blocking serotonin 2A receptors and histamine H1 receptors, both of which contribute to its sedating effects. At the low doses typically used for insomnia (25-100mg), the sedating properties tend to predominate over the antidepressant effects, which generally require higher doses (150-400mg). Trazodone may help reduce the time it takes to fall asleep and may improve sleep continuity throughout the night. Unlike benzodiazepines, it does not significantly suppress deep sleep stages, which some sleep specialists consider an advantage for overall sleep quality.
Side Effects
Common
- • Daytime drowsiness or grogginess, especially when starting treatment
- • Dizziness or lightheadedness
- • Dry mouth
- • Headache
- • Nausea or stomach discomfort
- • Blurred vision
Serious (Rare)
- • Priapism (prolonged, painful erection) — rare but requires immediate medical attention
- • Serotonin syndrome if combined with other serotonergic medications
- • Orthostatic hypotension (drop in blood pressure upon standing)
- • Cardiac arrhythmias, particularly at higher doses
- • Suicidal ideation — carries the standard antidepressant black box warning, particularly in younger adults
Who Is Eligible
Trazodone is typically prescribed to adults with insomnia who have not responded adequately to sleep hygiene measures alone. It may be particularly appropriate for patients with co-occurring depression or anxiety. It should be used with caution in patients taking other serotonergic medications, those with heart conditions, and individuals prone to orthostatic hypotension. Providers should evaluate a patient's full medication list before prescribing, as trazodone can interact with several drug classes.