Trazodone for ADHD

Trazodone is an antidepressant (SARI) that is sometimes helpful as a sleep aid for ADHD.
More on this at Krause.¹

• Phenylpiperazine
• Blockade of the 5HT2A receptors leads to an increase in dopamine in the striatum due to glutamate reduction and increases serotonergic neurotransmission via the 5-HT1A receptors
• Low dose (up to 50 mg): 5HT2A receptor antagonist
• Higher doses also have a serotonergic and antihistaminergic effect. At low doses (up to 50 mg) it has no serotonergic effect.
• Sleep-promoting in ADHD when taken in low doses (25 to 100 mg)
• Half-life 5 to 9 hours
• No impairment of sexual functions
• No increase in body weight
• Strongly inhibits α1 receptors
• Weakly inhibits α2 and H1 receptors
  • Acts in the opposite way to guanfacine as an α2 agonist, which in turn (taken in the evening) has a sleep-inducing effect
• Attenuating effect on tremor
• Not contraindicated in glaucoma and prostate problems
• No extrapyramidal effect (no motor restlessness)
• No potentiation of adrenergic transmission
• No anticholinergic activity, therefore does not have the typical side effects of tricyclic antidepressants
• Cross effects:
  • Should not be combined with MAO inhibitors or (especially if high doses) with serotonergic medication