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Trazodone

Also indexed as: Desyrel®

Trazodone is a weak serotonin reuptake inhibitor drug with other effects on brain neurotransmitters. It is used to treat people with depression. It is also used to treat people during cocaine withdrawal.

Interactions with Herbs

Digitalis (Digitalis lanata, Digitalis purpurea)
Digitalis refers to a family of plants commonly called foxglove that contain digitalis glycosides, chemicals with actions and toxicities similar to the prescription drug digoxin.

Trazodone was associated with increased serum digoxin levels in one case report.1 No interactions between trazodone and digitalis have been reported. Until more is known, trazodone and digitalis-containing products should be used only under the direct supervision of a doctor trained in their use.

Ginkgo (Ginkgo biloba)
There is one case report of an elderly patient with Alzheimer’s disease going into a coma while concurrently using trazodone and ginkgo.2 Until more is known, ginkgo should not be combined with trazodone except under supervision of a doctor.

St. John’s wort (Hypericum perforatum)
One report described a case of serotonin syndrome in a patient who took St. John’s wort and trazodone.3 The patient reportedly experienced mental confusion, muscle twitching, sweating, flushing, and ataxia. Until more is known, St. John’s wort should not be combined with trazodone except under expert clinical supervision.

Interactions with Foods and Other Compounds

Food
Trazodone should be taken with food.4

Alcohol
Trazodone may cause drowsiness or dizziness.5 Alcohol may compound these effects and increase the risk of accidental injury. To prevent problems, people taking trazodone should avoid alcohol.

Summary of Interactions for Trazodone

Depletion or interference None known
Adverse interaction Ginkgo*
St. John’s wort*
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Other (see text) Digitalis

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Rauch PK, Jenike MA. Digoxin toxicity possibly precipitated by trazodone. Psychosomatics 1984;25:334–5.

2. Galluzzi S, Zanetti O, Binetti G, et al. Coma in a patient with Alzheimer’s disease taking low dose trazodone and Gingko biloba. J Neurol Neurosurg Psychiatry 2000;68:679–80.

3. Demott K. St. John’s wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.

4. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Trazodone. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1990, 263i–3k.

5. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Trazodone. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1990, 263i–3k.