INTRODUCTION: Trazodone is an antidepressant belonging to the class of serotonin 
receptor antagonists and reuptake inhibitors. It is approved by the FDA for the 
treatment of depression. Insomnia is the most frequent reason for prescription 
of trazodone. It has also been proven useful in the treatment of anxiety 
disorders. Other off-label uses include the treatment of bulimia, 
benzodiazepine/alcohol dependence, fibromyalgia, central nervous system 
degenerative diseases (behavioral disorders in dementia and other organic 
disorders), schizophrenia, chronic pain disease and diabetic neuropathy, sexual 
dysfunction.
AREAS COVERED: This paper evaluates trazodone's efficacy and safety in its 
off-label uses. It also discusses the possibility that a combination of 
trazodone with SSRIs may prevent or treat some of the SSRI side effects, such as 
anxiety, insomnia and sexual dysfunction, in addition to synergically increasing 
SSRIs' antidepressant activity.
EXPERT OPINION: Few clinical trials have been conducted to evaluate trazodone's 
efficacy in the treatment of the diseases and symptoms for which it is often 
used in clinical practice. More studies are necessary to investigate possible 
new therapeutic indications, and to scientifically demonstrate the risk/benefit 
ratio for the many conditions for which trazodone is used, but not approved by 
the FDA.