Trazodone is commonly prescribed for sleep, anxiety, and depression. Because it’s often taken nightly and sometimes long term, many people ask the same practical question:
Does trazodone cause weight gain?
The short answer is: it can, but it’s not very common, and when weight changes do happen, they’re usually indirect rather than caused by the medication itself.
What Is Trazodone?
Trazodone is an antidepressant that affects serotonin activity in the brain. At lower doses, it’s frequently used off-label to treat insomnia, especially when sleep problems are connected to anxiety or depression. At higher doses, it’s used as an antidepressant.
Unlike some medications, trazodone is sedating rather than stimulating and does not strongly increase appetite on its own.
Can Trazodone Cause Weight Gain?
Weight gain is listed as a possible side effect, but it is considered uncommon.
Most clinical evidence suggests trazodone is:
- Generally weight-neutral
- Less likely to cause weight gain than medications like mirtazapine or certain SSRIs
- More likely to affect weight indirectly through sleep, energy, or activity changes
Some people notice mild weight gain, some notice no change, and others may even lose weight.
Why Weight Changes Can Happen on Trazodone
When people do experience weight changes, it’s often related to how trazodone affects sleep, mood, and daily routines.
Improved Sleep
Better sleep can normalize appetite and energy levels. If someone was under-eating or highly stressed before treatment, this normalization can look like weight gain even though it reflects stabilization.
Reduced Anxiety or Depression
As anxiety or depression improves, appetite may return. This is common during recovery and isn’t always a negative outcome, even if the number on the scale changes slightly.
Sedation and Activity Levels
Trazodone can cause grogginess, especially when starting or adjusting doses. Temporary decreases in activity may contribute to gradual weight changes if not addressed.
Individual Sensitivity
Everyone responds differently to serotonin-related medications. Some people are more sensitive to appetite or energy shifts, even with medications considered low risk for weight gain.
How Trazodone Compares to Other Antidepressants
| Medication | Relative Weight Gain Risk |
|---|---|
| Trazodone | Low |
| Fluoxetine (Prozac) | Low |
| Sertraline (Zoloft) | Low to moderate |
| Paroxetine (Paxil) | Higher |
| Mirtazapine (Remeron) | Higher |
| Amitriptyline | Higher |
Trazodone is often chosen specifically because it has a lower weight-gain profile compared to many alternatives.
Does Dose Matter?
Yes. Lower doses used for sleep are generally less likely to affect weight than higher doses used for depression. Dose increases, long-term use, and combining trazodone with other medications can all influence side effects over time.
When to Talk to a Provider
It’s worth checking in if:
- Weight changes feel rapid or distressing
- Appetite feels significantly altered
- Fatigue is interfering with daily functioning
- Other side effects are present
Medication adjustments or alternatives may help.
Across all programs at Montare Behavioral Health, medication management looks at the whole picture, including sleep, mood, physical health, and quality of life.
A Final Word
Trazodone does not commonly cause significant weight gain. When weight changes occur, they’re usually tied to improved sleep, reduced anxiety, or changes in activity rather than a direct metabolic effect of the medication.
If weight concerns come up during treatment, they’re worth addressing early. Mental health care should support both emotional wellbeing and physical health.
Frequently Asked Questions About Trazodone and Weight
Does trazodone cause weight gain?
Trazodone can cause weight gain in some people, but it is considered uncommon. Most individuals experience little to no weight change. When weight gain does occur, it’s often mild and related to indirect effects like improved sleep or appetite rather than a direct effect on metabolism.
Is trazodone more likely to cause weight gain than other antidepressants?
No. Trazodone is generally less likely to cause weight gain than medications such as mirtazapine, paroxetine, or tricyclic antidepressants. It is often chosen specifically because it has a lower risk of weight-related side effects.
Can trazodone cause weight loss?
Yes. Some people experience no appetite change or even mild weight loss, especially early in treatment. Individual responses vary depending on sleep quality, activity level, and underlying mental health symptoms.
Sources
- U.S. National Library of Medicine. (n.d.). Trazodone: MedlinePlus drug information. https://medlineplus.gov/druginfo/meds/a681038.html
- U.S. National Library of Medicine. (n.d.). Trazodone hydrochloride tablet: Drug label information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1510cf89-a2ec-4ed5-80cb-bae84f9ec0a7
- Mayo Clinic Staff. (n.d.). Trazodone (oral route): Description and side effects. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/trazodone-oral-route/description/drg-20061280
- Cleveland Clinic. (n.d.). Trazodone tablets. https://my.clevelandclinic.org/health/drugs/18658-trazodone-tablets
- Shin, J. J., & Saadabadi, A. (2024). Trazodone. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470560/
- Mayo Clinic Staff. (n.d.). Antidepressants and weight gain: What causes it? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-weight-gain/faq-20058127