Substance guides

Trazodone for sleep in recovery: Is it safe?

Published May 8, 2025 · 7 min read · Updated April 2026
Last medically reviewed: April 2026
Reviewed for accuracy by licensed clinical professionals. Editorial process.

Trazodone is one of the most commonly prescribed medications for insomnia in recovery settings — and for good reason. It provides sleep without the addiction risk of benzodiazepines or Z-drugs, making it particularly appropriate for people with substance use disorder histories.

How it works

Trazodone is technically an antidepressant (SARI — serotonin antagonist and reuptake inhibitor), but at the low doses used for sleep (25-100mg), its primary effect is sedation through histamine and serotonin receptor blockade. At higher doses (150-400mg), it functions as an antidepressant. For sleep, the low-dose use produces drowsiness within 30-60 minutes and helps with both falling asleep and staying asleep.

Safety in recovery

Trazodone has minimal abuse potential — it does not produce euphoria, is not reinforcing, and is not a controlled substance. It does not interact dangerously with most MAT medications (buprenorphine, naltrexone). It does not cause the metabolic side effects (weight gain, diabetes risk) associated with Seroquel. For these reasons, it is widely considered safe and appropriate for insomnia in people with substance use disorders. Common side effects include morning drowsiness (usually improves with dose adjustment), dry mouth, dizziness upon standing, and rarely, priapism (persistent erection) in men, which is a medical emergency.

Limitations

Trazodone is not effective for everyone. Some people find the sedation insufficient or develop tolerance over time. It can cause excessive morning grogginess, particularly at higher doses. It should not be combined with other serotonergic medications without careful supervision due to serotonin syndrome risk.

Substance abuse treatment facilities

Lionheart Recovery Center
Las Vegas, NV
Call 702-886-1117
Tides Family Services
West Warwick, RI
Call 401-822-1360
Sion Hill Treatment
Christiansted, VI
Call 340-719-9900
UAB Hospital
Birmingham, AL
Call 205-975-2710
Find a location near you →