Can you take trazodone and Lexapro?

In this article:

• Trazodone and Lexapro
• Potential side effects
• Dosing schedule
• Is it safe to mix trazodone and Lexapro?

In this article

• Trazodone and Lexapro
• Potential side effects
• Dosing schedule
• Is it safe to mix trazodone and Lexapro?

Finding the right medication to manage a mental health condition is difficult, and it can take some trial and error to settle on an effective treatment plan. Two commonly prescribed medications for various mental health conditions are trazodone and Lexapro. 

As a brand-name prescription drug, Lexapro is FDA-approved to treat major depressive disorder and anxiety disorders. Commonly referred to by its generic name, escitalopram, Lexapro is a selective serotonin reuptake inhibitor (SSRI) that works by increasing serotonin levels in the central nervous system (CNS). Trazodone (Desyrel)—a generic prescription medication—is also an antidepressant. It’s used to treat depression and works by enhancing serotonin activity in the CNS. 

Although each medication is considered safe and effective on its own, taking Lexapro and trazodone together may be risky. Read on to learn more about the potential risks of combining trazodone and Lexapro. 

Can you take trazodone with Lexapro?

In certain situations, people may consider combining trazodone and Lexapro medications. In theory, there may be benefits to doing so, but taking trazodone with Lexapro generally isn’t safe. 

Although trazodone is FDA-approved for depression, it’s primarily known for its off-label use as a sleep aid due to its sedative effects. In a 2017 systematic review, researchers concluded that low-dose trazodone is effective for insomnia in people with or without depression. Lexapro, on the other hand, is used to treat depression and anxiety. Because insomnia is a common symptom of depression, combining trazodone and Lexapro may appear to be a comprehensive treatment plan, especially since sleep deficiency and poor sleep quality may be linked to anxiety and depression. But, doing so can increase your risk of serious side effects, such as serotonin syndrome, heart rhythm problems, and difficulty focusing. If you’re experiencing insomnia in addition to anxiety or depression, it’s best to consult a healthcare provider for medical advice about your treatment options. They can recommend medications that are safe and effective for your condition. 

What happens if you take trazodone and Lexapro together?

Trazodone and Lexapro are known to interact with one another, and their combined use can result in serious adverse effects. 

Serotonin syndrome

Serotonin syndrome is a rare and potentially life-threatening condition that occurs when there are excessive levels of serotonin—a neurotransmitter (chemical) involved in regulating your mood, appetite, sleep, and other bodily functions—in your system. On rare occasions, serotonin syndrome can occur while taking one drug that increases serotonin levels. However, it is more likely to occur if you’re taking two or more serotonin-raising drugs at a time. Trazodone and Lexapro both work by boosting serotonin levels in your CNS. When they’re combined, your risk of serotonin syndrome increases. Symptoms of serotonin syndrome may include:

• Changes in mental status
• Tremors
• Muscle tightness
• High blood pressure
• Excessive sweating
• Overactive reflexes

Heart rhythm problems

According to its prescribing information, Lexapro can affect the heart’s rhythm by prolonging the QT interval—the time it takes for the lower chambers of the heart to contract and then fully relax—especially if it’s taken at high doses. Trazodone is also known to cause QT prolongation. When trazodone and Lexapro are combined, the likelihood of QT prolongation can increase. Symptoms of QT prolongation may include palpitations, shortness of breath, chest pain, lightheadedness, and fainting.  

Impaired focus and coordination

Because both medications work by altering the levels of certain chemicals in the brain, trazodone and Lexapro have warnings regarding impaired cognition and coordination. They also both can cause drowsiness as a side effect, therefore, when used together, it can lead to an increased risk of drowsiness and difficulty focusing, thinking, or reacting. Due to this risk, it’s not recommended to drive or do any activities that require your focus while taking either medication until you know how it affects you. 

Mania

If you have bipolar disorder, taking antidepressants, such as trazodone or Lexapro, can cause a manic episode, according to trazodone’s and Lexapro’s prescribing information. For this reason, healthcare professionals will typically screen for any personal or family history of bipolar disorder, mania, or hypomania before starting antidepressant therapy. This may occur with the use of one antidepressant agent, but the risk is more pronounced if two antidepressants, such as trazodone and Lexapro, are combined. 

Can I take Lexapro in the morning and trazodone at night?

In some cases, drug interactions can be prevented by separating the administration of the drugs. However, there are other cases where combining drugs should be avoided altogether. Unfortunately, that is the case with trazodone and Lexapro, as it’s recommended to avoid taking these drugs together entirely, according to the Medscape interaction checker. 

Is it safe to mix trazodone and Lexapro?

No, it’s not recommended to mix trazodone and Lexapro. While doing so may theoretically offer some benefit for those with insomnia and depression, it can increase your risk of serious adverse effects. These may include serotonin syndrome, heart rhythm problems, impaired focus and coordination, and mania. A healthcare provider can advise you on the best treatment plan for your condition.