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The older sedative-hypnotics that have a prolonged half-life increase the risk for next-day sedation and daytime psychomotor impairment and pose an increased risk for abuse and dependence.

Other complications of benzodiazepine use include tolerance, withdrawal, abuse, and rebound insomnia.

Some of these side effects will disappear with the passage of time or with a decrease in the dosage.

The anticholinergic effects of dry mouth, blurred vision, constipation, and difficulty in urination; postural hypotension; tachycardia, loss of sex drive; erectile failure; increased sensitivity to the sun; weight gain; sedation (sleepiness); increased sweating.

The results from such a study are plotted in Figure 3.1 as a classic concentration-response curve in which the Y-axis is the response (ie, effect of the drug) and the X-axis is increasing concentration of the investigational drug (ie, the potential inhibitor).

In the case of the serotonin uptake pump, the effect is the degree of slowing or inhibition of the uptake of the radioactive serotonin into the synaptosomes.

The therapeutic effects of trazodone, like other antidepressants, appear slowly.

Maximum benefit is often not evident for at least two weeks after starting the drug.

All can be considered first-line agents for insomnia; agent choice is largely dictated by past trials, cost, side-effect profile, drug interactions, and patient preference. Possible side effects initially (including insomnia, tremor, or both) may last up to the first two to three weeks of treatment.If daytime sedation or other side effects are bothersome to the patient, the physician may suggest taking the full dosage at night before bed. Not recommended while breast-feeding and used only with physician consent while pregnant. Anticholinergic effects are stronger than most other antidepressants. Avoid during last three months of pregnancy to prevent withdrawal symptoms in infant. The most common side effects are headaches, drowsiness, dry mouth, constipation and insomnia. Raise the dose over the next few weeks to a maximum of 300 mg. It should be noted, however, that trazodone has not received official approval from the United States Food and Drug Administration (FDA) for these secondary uses.Trazodone acts to change the balance of naturally occurring chemicals in the brain that regulate the transmission of nerve impulses between cells.

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