Trazodone Side Effects in Seniors: What Women 65+ Must Know

Trazodone (sometimes spelled Trazadone) is a prescription antidepressant that has been used for decades. While it was originally developed to treat depression, it is now commonly prescribed in lower doses to help with sleep, especially in older adults. Many women over 65 take trazodone because it is not a benzodiazepine and is often viewed as a gentler option.

However, aging changes how the body handles medications. What feels mild at 40 can behave very differently at 70. Understanding how trazodone affects older women, including its side effects and risks, is key to using it safely.

This guide is based on widely accepted medical guidance, including FDA prescribing information, geriatric medicine standards, and clinical psychiatry research.

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What Is Trazodone and Why Is It Prescribed to Seniors?

Trazodone is classified as a serotonin antagonist and reuptake inhibitor (SARI). In plain terms, it affects serotonin levels in the brain, which influence mood, sleep, and anxiety.

For women 65 and older, trazodone is most often prescribed for:

• Insomnia or poor sleep quality
• Depression, especially when sleep problems are present
• Anxiety symptoms related to depression

Doctors often choose trazodone because it:

• Is not habit-forming
• Has less risk of dependence than many sleep medications
• Is available in low doses suitable for seniors

That said, "safer" does not mean "risk-free."

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Why Side Effects Can Be Stronger After Age 65

As we age, our bodies process drugs differently. In older women especially:

• Liver metabolism slows, so medication stays in the body longer
• Kidney function declines, affecting drug clearance
• Body composition changes, increasing drug sensitivity
• Multiple medications raise the risk of interactions

Because of these factors, seniors may experience side effects at lower doses than younger adults.

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Common Trazodone Side Effects in Women 65+

Many side effects are mild and improve over time, especially when starting at a low dose. Still, they should not be ignored.

Most Common Side Effects

• Drowsiness or sedation
• Dizziness or lightheadedness
• Dry mouth
• Headache
• Nausea or constipation
• Blurred vision
• Fatigue or weakness

These effects are especially noticeable in the morning or after dose increases.

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Fall Risk: A Major Concern for Seniors

One of the most important risks of trazodone in older women is falls.

Trazodone can cause:

• Orthostatic hypotension (a drop in blood pressure when standing)
• Impaired balance
• Delayed reaction time

Falls can lead to:

• Hip fractures
• Head injuries
• Loss of independence

To reduce risk:

• Stand up slowly from bed or chairs
• Use night lights when walking at night
• Avoid alcohol
• Report dizziness to your doctor promptly

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Heart-Related Side Effects to Be Aware Of

Trazodone can affect heart rhythm, which is especially relevant for seniors.

Possible cardiac-related effects include:

• Irregular heartbeat
• Palpitations
• Prolonged QT interval (seen on ECGs)

Women over 65 with:

• Heart disease
• Electrolyte imbalances
• A history of arrhythmias

should be monitored carefully. Any new chest discomfort, fainting, or racing heart should be treated as urgent.

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Cognitive and Mood-Related Effects

Although trazodone is used to help mood and sleep, it can sometimes cause unexpected mental effects in seniors.

These may include:

• Confusion
• Memory problems
• Daytime grogginess
• Worsening depression
• Increased anxiety in rare cases

If family members notice personality changes, confusion, or withdrawal, it's important to speak to a doctor.

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Rare but Serious Side Effects

While uncommon, some side effects can be life-threatening and require immediate medical attention.

Seek urgent care if you experience:

• Fainting
• Seizures
• Severe allergic reactions (swelling of face or throat)
• Serotonin syndrome, which may include:
  • Fever
  • Muscle stiffness
  • Rapid heartbeat
  • Confusion or agitation

These risks increase when trazodone is combined with other antidepressants, migraine medications, or certain supplements.

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Medication Interactions Seniors Should Know About

Older women are more likely to take multiple prescriptions, which increases interaction risk.

Trazodone may interact with:

• Other antidepressants
• Blood pressure medications
• Blood thinners
• Sleep aids or sedatives
• Certain heart medications

Never start or stop a medication without checking with your healthcare provider.

If you're currently on antidepressants and experiencing new or unusual symptoms, a free AI-powered symptom checker can help you understand what might be happening and whether you should reach out to your doctor.

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Dosing Considerations for Women 65+

In seniors, the guiding principle is "start low and go slow."

Typical considerations:

• Lower starting doses than younger adults
• Slower dose increases
• Regular reassessment of benefit vs. side effects

For sleep, many seniors take much lower doses than those used for depression. More is not always better.

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Is Trazodone (Trazadone) Safe for Long-Term Use?

Trazodone has been used long-term in older adults, but ongoing monitoring is essential.

Long-term considerations include:

• Continued fall risk
• Persistent daytime sedation
• Changes in cognition
• Interaction risks as new medications are added

Periodic medication reviews with a doctor or pharmacist are strongly recommended.

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When to Speak to a Doctor Immediately

Do not wait if you experience:

• Fainting or collapse
• Sudden confusion
• Chest pain or irregular heartbeat
• Severe dizziness or falls
• Signs of serotonin syndrome

These can be life-threatening and need urgent medical evaluation.

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Final Thoughts for Women 65+

Trazodone (or Trazadone, as it's sometimes called) can be helpful for sleep and mood in older women, but it is not harmless. The same qualities that make it calming can also increase risks, particularly for falls, heart rhythm issues, and confusion.

The goal is not fear—but informed use.

If you or a loved one is taking trazodone:

• Monitor side effects
• Keep medication lists up to date
• Have regular check-ins with a healthcare provider
• Speak to a doctor about any symptoms that feel severe, sudden, or concerning

Used thoughtfully and with medical guidance, trazodone can be part of a safe and effective treatment plan for many women over 65.