Trazodone can produce side effects that vary in occurrence and severity among individuals. Common side effects may include edema (swelling), blurred vision, drowsiness, syncope (fainting), fatigue, diarrhea, nasal congestion, weight loss, dry mouth, and headache.
Desyrel (trazodone) has several long-term adverse effects. These include sedation, weight gain, and persistent sexual dysfunction. It can also cause orthostatic hypotension, increasing the risk of falls, and potential cardiac arrhythmias. There is a possible risk of birth defects if taken during pregnancy.
The half-life of a medication is relevant to understanding its effects and potential withdrawal symptoms. Half-life of trazodone varies depending on the formulation. For trazodone immediate release (IR), the half-life is 5 - 13 hours. For the extended release formulations, the half-life is up to 24 hours.
Hyperbolic tapering is a neurobiology-based tapering method, based on the relationship between dose changes and brain activity. It is the only science-based method for stopping antidepressants, and is the backbone of Outro's personalized methodology. tapering based on this method gradually backs you out of the drug with reductions following this natural curve, with the size of dose reduction getting smaller as the dosage gets lower. As very low doses (e.g. 1 or 2mg) have much larger effects than people expect, many people need to taper down to very small doses before stopping so that the final ‘jump’ to zero is not too large a shock to the nervous system.
Compounded medications are often crucial in the tapering process, as commonly available dose sizes aren't small enough to reach the sizes necessary to follow a safe tapering plan. For example, the smallest usually available dose size for venlafaxine is 37.5mg (a drop from 37.5mg to 0mg can easily lead to debilitating withdrawal symptoms).
Hyberbolic Tapering
A science-based approach that helps reduce the risk of withdrawal symptoms and relapse.
Expert Clinicians
Outro clinicians are trained by world-leading experts in medication deprescribing.
Use science-based methods
Hyperbolic tapering is the only science-based discontinuation method, based on the neuroscience of how dose changes impact withdrawal symptoms.
Go slowly & check in
Reduce medications at a rate that the body and mind can tolerate, and make sure to check in to know if you're going to quickly.
Consider compounded doses
When getting to dose sizes smaller than what are usually available, compounding pharmacies can help formulate custom pills and liquids.
Developed by world-leading experts in deprescribing
Outro's interdisciplinary team of clinicians, researchers and patient advocates is dedicated to building safe, evidence-based options for people looking to live life free of medications.
FAQs
Explore commonly asked questions about Outro's services, medication withdrawal, tapering and more.
Outro is for people 18 years and older who are currently taking an antidepressant medication and thinking about decreasing or stopping the medication altogether.
As a virtual care service, Outro’s services are currently not available for people in certain situations or with certain conditions. These include (but are not limited to) people who:
- Have active and serious substance abuse issues
- Have been diagnosed with dementia
- Have been diagnosed with schizophrenia or schizoaffective disorder
- Have been hospitalized for bipolar disorder in the past 12 months
- Have attempted to end their life in the past 12 months
- Are actively suicidal or in crisis
Safe antidepressant deprescribing requires a comprehensive approach that is often difficult for an individual prescriber to provide, due to the time required. It also requires up-to-date knowledge on the latest techniques in tapering antidepressants that are not yet widely taught in North America. Think of Outro as a specialist in tapering.
At Outro, we walk with you every step of the way. Our specialized, high-touch care team takes time to get to know you and your goals, and provides an advanced, individualized approach to tapering off antidepressants informed by the latest guidance and clinical evidence. Through Outro’s app, your symptoms and progress are continuously monitored by your Provider, who can reach out to offer coping strategies or adapt your care plan accordingly. If you have questions or concerns that arise in between appointments, your Outro provider is available via 1-to-1 chat.
Many people have difficulties when they try to go off antidepressants. Our team of expertly trained clinicians will develop a tailored tapering program, informed by the latest scientific evidence and designed to minimize withdrawal effects - even for these people who have tried to stop before.
Hyperbolic tapering (sometimes called the Horowitz-Taylor method) is based on the fact that as antidepressant dose goes up, drug action on brain cells increases, but not in equal steps, higher dosages having less and less additional influence – a decreasing return on investment. The graph showing this is called a hyperbolic curve (goes up faster at low doses and flatter at higher doses).
Tapering based on this method gradually backs you out of the drug with reductions following this natural curve, with the size of dose reduction getting smaller as the dosage gets lower. As very low doses (e.g. 1 or 2mg) have much larger effects than people expect, many people need to taper down to very small doses before stopping so that the final ‘jump’ to zero is not too large a shock to the nervous system.
Compounded medications are often crucial in the tapering process, as commonly available dose sizes aren't small enough to reach the sizes necessary to follow a safe tapering plan. For example, the smallest usually available dose size for venlafaxine is 37.5mg (a drop from 37.5mg to 0mg can easily lead to debilitating withdrawal symptoms).
The costs of medications are not included in your Outro subscription. To help you in your taper, Outro works in partnership with leading compounding pharmacies to provide the most reliable and affordable medication formulations and sizes. Speak with your Outro provider to learn more!
We currently offer taper management for antidepressant medications (e.g., duloxetine, escitalopram, sertraline, venlafaxine). You can see the full list here.
We are making preparations to expand to other psychotropic medications like benzodiazepines and gabapentinoids, which also follow the hyperbolic tapering method. You can express an interest in tapering these medications in our sign-up form.
Outro is currently serving patients in California. If you are located in another US state, be sure to express your interest via our sign-up form. We'll be providing regular updates and announcements as we expand our reach.