The elderly generally require a lower dosage schedule and are more susceptible to adverse reactions. If the elderly patient is unable to take an SSRI antidepressant, however, trazodone may be preferred over a tricyclic antidepressant because of the lower incidence of cardiac effects. Trazodone causes sedation and should be used with caution in patients with alcoholism. The sedative effects of alcohol can be additive to trazodone's effects. Trazodone is classified as FDA pregnancy category C. Adequate studies have not been done in humans and benefits versus risks should be considered.
Trazodone is excreted into the breast milk.
Although no problems have been documented during breast-feeding, the benefits and risks should be taken into account. An interval of 14 days is recommended between cessation of an irreversible MAOI agent and initiation of trazodone therapy. Guanabenz can lead to increased circulation of catecholamines. Concomitant use of trazodone could lead to hypertension, especially during the second week of antidepressant therapy. Occasionally, the hypertension will occur within the first few days of tricyclic antidepressant therapy.