Trazodone: Independent Evidence on Depression, Sleep, Side Effects & Withdrawal

Table of contents

• Evidence summary
• What trazodone is
• How it works
• What it is prescribed for
• What works and what does not
• Benefits by claim
• Risks and all side effects
• All interactions
• Who should avoid trazodone
• Dosage and how to take it
• Follow the money: who makes it and who funded the evidence
• Related research
• Frequently asked questions
• Sources and funding notes

Evidence summary

Independent evidence and credibility scorecard

Independence tier: 1 means no money from anyone selling trazodone or a competing product, and 4 means funded by a seller. Credibility grade: A is highest and D is lowest.

What trazodone is

Trazodone is an antidepressant available on prescription only. The NHS says it is "used to treat depression and anxiety" and comes as tablets, capsules or a liquid (NHS).

• Chemistry. It is a triazolopyridine derivative, "chemically unrelated to known tricyclic, tetracyclic and other antidepressant agents". Its ATC code is N06AX05, "other antidepressants" (UK SmPC).
• What class it belongs to. The literature usually calls it a serotonin antagonist and reuptake inhibitor, or SARI (Fagiolini et al., CNS Drugs 2012). Current US generic labels describe it as "a selective serotonin reuptake inhibitor and 5HT2 receptor antagonist" (FDA label). It should not be confused with standard SSRIs such as sertraline, which do not have trazodone's strong sedating receptor effects.
• Who developed it. Angelini Pharma of Rome, Italy, says its research "has a rich legacy of discovering and developing key active ingredients, such as trazodone". It still sells trazodone as Trittico (Angelini Pharma company profile).
• US approval. The first US approval was for the brand Desyrel (NDA 018207), approved on 24 December 1981. Drugs@FDA now lists the sponsor as Pragma and the product as discontinued (Drugs@FDA).
  • A once-daily extended-release version, Oleptro (Angelini Pharma, approved 2 February 2010), is also discontinued (Drugs@FDA).
  • An oral solution, Raldesy (10 mg/mL), was approved in November 2024 (Drugs@FDA).
• Generic status. Trazodone has been generic for decades. openFDA lists 36 US application records for trazodone, of which 33 are generic (ANDA) applications (openFDA query, 26 September 2026).
• In the UK. It is a prescription-only medicine. The branded capsule Molipaxin is held by Zentiva Pharma UK Limited, London (UK SmPC).

How it works

The FDA label says the mechanism of trazodone's antidepressant action "is not fully understood". It is thought to relate to "enhancement of serotonergic activity in the CNS" (FDA label).

In laboratory binding studies it acts on several targets. The lower the Ki number, the more strongly trazodone binds:

• 5-HT2A serotonin receptor: blocks it strongly (Ki 35.6 nM).
• Serotonin transporter: blocks reuptake only weakly (Ki 367 nM).
• Alpha-1 adrenergic receptors: blocks them (α1A Ki 153 nM). The label links this to postural hypotension, the drop in blood pressure on standing that causes dizziness and fainting.
• Other receptors: blocks 5-HT2B, 5-HT2C and α2C receptors, and is a partial agonist at 5-HT1A.

This receptor profile helps explain why the dose matters. A narrative review by Cuomo and colleagues describes sedative and anxiety-reducing effects at 25–75 mg and a full antidepressant effect at 150–300 mg (Cuomo et al., Ann Gen Psychiatry 2026). The authors declared no competing interests relevant to the work. It is expert opinion, not a trial.

Pharmacokinetics.

• Absorption: peak blood levels come about 1 hour after a dose on an empty stomach, or about 2 hours with food (FDA label).
• Metabolism: mainly by the liver enzyme CYP3A4, to an active metabolite, m-chlorophenylpiperazine (mCPP) (FDA label).
• Half-life: the terminal elimination half-life is 5 to 13 hours (UK SmPC).
• Older adults: in people aged 65–74, the half-life was about twice as long as in 23–30-year-olds, with "significantly higher plasma concentrations" (UK SmPC). This matters for next-morning drowsiness and falls.

What it is prescribed for

Licensed uses

• UK: "Anxiety, depression, mixed anxiety and depression" (UK SmPC).
• US: "treatment of major depressive disorder (MDD) in adults" only (FDA label).
• Insomnia: trazodone is not licensed for insomnia in either country. The Cochrane review notes that no antidepressant it studied is licensed for insomnia (Everitt 2018).

Where guidelines place it

How widely it is used off-label

Off-label use for sleep is extensive and growing:

• Canada: in Quebec primary care, trazodone for insomnia was the single most common off-label antidepressant use, at 26.2% (95% CI 21.9% to 30.4%) of all off-label antidepressant prescriptions (Wong et al., BMJ 2017; funded by the Canadian Institutes of Health Research).
• US, all adults: among an average of 16.6 million commercially insured adults a year, the share given low-dose trazodone (under 150 mg/day) rose from 1.25% in 2011 to 1.82% in 2018. Over the same period zolpidem fell from 4.56% to 2.50% (Wong et al., JAMA 2020).
• US, adults with diagnosed insomnia: low-dose trazodone use rose from 8.68% to 14.46% (same study). The rise continued after the 2017 AASM guideline discouraged it.
• US, earlier data: the national NHANES survey had already found zolpidem and trazodone to be the most-used prescription medicines for insomnia (Bertisch et al., Sleep 2014).
• Nursing homes: in Ontario, residents who stopped an antipsychotic started trazodone at an 82% higher rate than those who continued (adjusted HR 1.82, 95% CI 1.66–2.00). The authors interpret this as "substitution" (Harris et al., JAMDA 2024).

What works and what does not

Benefits by claim

Depression

The independent benchmark is the 2018 Lancet network meta-analysis by Cipriani and colleagues, which covered 522 trials and 116,477 participants. Every one of the 21 antidepressants was more effective than placebo. Response odds ratios ranged from 2.13 (amitriptyline) down to 1.37 (reboxetine) (Cipriani et al., Lancet 2018).

Trazodone did not do well in head-to-head comparisons:

• Efficacy: fluoxetine, fluvoxamine, reboxetine and trazodone "were among the least efficacious drugs" (ORs 0.51–0.84).
• Tolerability: trazodone was among the seven drugs with "the highest dropout rates" (ORs 1.30–2.32).
• Authors' conclusion: reboxetine, trazodone and fluvoxamine had "generally inferior efficacy and acceptability profiles compared with the other antidepressants, making them less favourable options."
• Certainty: the overall certainty of evidence was "moderate to very low".

Clinical significance. Across antidepressants, the average advantage over placebo is modest. An analysis of individual patient data held by the FDA put it at 1.75 points on the 17-item Hamilton depression scale (Stone et al., BMJ 2022), and an independent re-analysis of the Cipriani data found 1.97 points (Munkholm et al., BMJ Open 2019). The placebo response in trials is large. Published trials have also overstated benefit: Turner and colleagues found that 94% of antidepressant trials looked positive in journals, compared with 51% in FDA files (Turner et al., NEJM 2008). We did not find a trazodone-specific drug-versus-placebo effect size in a text-accessible independent source, so we do not quote one.

Insomnia

AASM 2017. After applying its inclusion rules, the AASM task force found a single trial of trazodone 50 mg: 187 adults with sleep-onset insomnia, treated for 14 nights, with self-reported outcomes. Compared with placebo (Sateia et al., 2017):

• time to fall asleep fell by 10.2 minutes;
• total sleep time rose by 21.8 minutes;
• time awake after first falling asleep fell by 7.7 minutes;
• awakenings fell by 0.4 a night;
• sleep quality was not significantly improved.

The task force concluded that "none of the sleep outcome variables improved to a clinically significant degree". It downgraded the evidence for "potential publication bias". Its explanation of patient preference is revealing: most patients would still choose trazodone "based on the perception of trazodone as a 'safer' sleep-promoting agent by many physicians". The recommendation not to use it is graded WEAK.

Cochrane 2018. The Everitt review found 23 randomised trials (2,806 participants) of antidepressants for insomnia. Seven used trazodone (Everitt et al., 2018):

• Self-rated sleep: three trazodone trials (370 participants) pooled to a "moderate improvement in subjective sleep outcomes over placebo" (SMD −0.34, 95% CI −0.66 to −0.02).
• Sleep-lab measures: two trials that used polysomnography "found little or no difference in sleep efficiency" (MD 1.38 percentage points, 95% CI −2.87 to 5.63; 169 participants).
• Side effects: there was low-quality evidence of more adverse effects than placebo, such as morning grogginess, dry mouth and thirst.
• Conclusion: "There may be a small improvement in sleep quality with short-term use of low-dose doxepin and trazodone compared with placebo". There was no evidence for long-term use.

Other meta-analyses.

• Yi 2018: seven placebo-controlled trials (429 patients). No significant improvement in sleep efficiency (SMD 0.09, 95% CI −0.19 to 0.38). Better perceived sleep quality (SMD −0.41, 95% CI −0.82 to −0.00) and fewer awakenings (SMD −0.51). No significant difference in dropouts (Yi et al., Sleep Med 2018).
• Zheng 2022: eleven sleep-lab trials (466 participants). More total sleep time (MD 39.88 minutes, 95% CI 14.44–65.32), but the certainty of evidence was "very low" for that outcome, and daytime drowsiness was more common (OR 2.53) (Zheng et al., Sci Rep 2022).
• De Crescenzo 2022: the largest insomnia network meta-analysis (154 double-blind trials, 44,089 participants) concluded that trazodone, like several licensed drugs, "can be effective in the acute treatment of insomnia but [is] associated with poor tolerability, or information about long-term effects is not available" (De Crescenzo et al., Lancet 2022).

Reading this honestly. Trazodone makes people drowsy, and people who take it tend to rate their sleep a little better. Evidence that it objectively improves sleep, or helps over months, is weak. Cognitive behavioural therapy for insomnia (CBT-I) remains the first-line treatment in the European guideline (Riemann et al., 2023).

Insomnia with depression

A 2026 meta-analysis of 30 studies in depressed patients (16 randomised) found that trazodone "notably improved" total sleep time and sleep efficiency. It also found that trazodone "frequently led to dizziness, sedation, headache, nausea, and somnolence" (Zhang et al., J Affect Disord 2026). The authors declared no competing interests. Almost half of the included studies were non-randomised, so the evidence is weaker than the headline suggests.

Risks and all side effects

Common side effects

The NHS lists these common side effects: feeling sleepy, dizzy or tired; headaches; feeling sick; constipation; muscle pain; and dry mouth (NHS).

In the controlled trials behind the US label, these were more common with trazodone than with placebo (FDA label, Table 2):

These trials used antidepressant doses, which are higher than most sleep prescriptions. In the AASM's 50 mg insomnia trial, headache (30% vs 19%) and somnolence (23% vs 8%) were the main excess side effects (AASM 2017).

Serious risks and regulator warnings

Falls and fractures in older adults

This is the key safety question for the off-label sleep use, because trazodone is often chosen specifically for older people as a "gentler" option. The independent evidence does not support that assumption:

• Versus benzodiazepines (nursing homes): Ontario nursing-home residents newly given low-dose trazodone (7,791 propensity-matched pairs) had a 90-day fall-injury rate of 5.7%, against 6.0% for new benzodiazepine users (HR 0.94, 95% CI 0.83–1.08). The authors concluded trazodone "was no safer" (Bronskill et al., JAGS 2018).
• Versus antipsychotics (dementia): among 6,588 trazodone users and 2,875 atypical antipsychotic users in long-term care, falls or major osteoporotic fractures were similar (weighted HR 0.89, 95% CI 0.73–1.07), as were hip fractures (HR 0.92). Mortality was lower with trazodone (HR 0.75, 95% CI 0.66–0.85). The authors' verdict: trazodone "is not a uniformly safer alternative" (Watt et al., CMAJ 2018).
• Versus zopiclone (Alberta): injurious falls and fractures were similar (ITT-weighted HR 1.15, 95% CI 0.90–1.48). The authors concluded "one medication should not be used in lieu of the other" (Watt et al., Can Geriatr J 2023).
• In hospital (US): in a US academic hospital, trazodone exposure was linked to more in-hospital falls (3.3 vs 2.0 per 1,000 hospital days; adjusted HR 1.2, 95% CI 1.1–1.5). The link was weaker than for benzodiazepines (aHR 1.8) (Herzig et al., Sleep 2021).
• Blood pressure (Italy): in a small study of 123 hypertensive outpatients aged 75 and over, the 12 trazodone users had larger blood-pressure drops on standing. They also had more syncope and falls (58.3% vs 21.2%), although the association was not confirmed after adjusting for dementia (Rivasi et al., Drugs Aging 2025; funded by a savings-bank foundation and EU NextGenerationEU).

Not every study points the same way. A Japanese single-hospital case-control study found a lower adjusted odds of falls with trazodone (OR 0.47, 95% CI 0.27–0.80) (Shimizu et al., 2022). A very large Medicare claims study found trazodone and benzodiazepines had the greatest fall risk among insomnia drugs (Amari et al., BMC Geriatr 2022). That study was funded by Eisai, which sells a competing insomnia drug, and its authors cautioned about residual confounding. Overall, the evidence is observational, but the most independent and best-matched studies consistently find trazodone no safer than the drugs it replaces.

Withdrawal and dependence

• Withdrawal symptoms: stopping suddenly can cause withdrawal symptoms. The NHS says doctors reduce the dose "over several weeks or months" (NHS). The UK SmPC names nausea, headache and malaise as withdrawal symptoms. The US label lists a wider discontinuation syndrome, including dizziness, "electric shock sensations", anxiety, insomnia and, rarely, seizures (FDA).
• Addiction: trazodone is not a controlled substance, and "no indication of drug-seeking behavior was seen in the clinical studies" (FDA). The SmPC states "there is no evidence" of addictive properties.
• Stopping a sleep prescription: after months of nightly use, some people find they cannot sleep without it. We found no controlled study quantifying this for trazodone.

Sexual side effects

Besides priapism, the US label lists reduced sex drive, impotence, increased sex drive and retrograde ejaculation among less common trial events (under 2%). The UK SmPC lists decreased libido (FDA; SmPC). Reviews often describe a "low risk of sexual dysfunction" compared with SSRIs (Cuomo 2026). These are narrative reviews, not head-to-head trials, so treat the comparison as plausible but unproven.

UK regulator check. A GOV.UK search on 26 September 2026 found no MHRA Drug Safety Update specific to trazodone's risks. It returned only product-defect and recall notices for particular batches (GOV.UK search).

All interactions

Who should avoid trazodone

• Contraindications (UK): known sensitivity to trazodone; alcohol intoxication or intoxication with hypnotics; acute myocardial infarction (UK SmPC).
• Contraindications (US): taking an MAOI now or within the past 14 days (FDA).
• Use only with specialist care or extra caution:
  • heart disease, conduction problems, a history of arrhythmia, or congenital long QT;
  • low potassium or magnesium;
  • epilepsy;
  • liver or severe kidney impairment;
  • hyperthyroidism;
  • bipolar disorder or a family history of it;
  • psychosis;
  • narrow-angle glaucoma;
  • prostate enlargement or difficulty passing urine;
  • conditions that predispose to priapism, such as sickle cell anaemia, multiple myeloma, leukaemia or Peyronie's disease (SmPC; FDA).

  The NHS also flags a past history of self-harm or suicidal thoughts (NHS).

• Children and teenagers: the SmPC says it should not be used under 18, and it is not approved for children in the US.
• Older adults: in very elderly or frail people the SmPC recommends a lower starting dose and says single doses above 100 mg "should be avoided". Because the half-life roughly doubles, blood pressure drops on standing, and falls data show no safety advantage, older adults face the greatest risk from off-label night-time use.
• Pregnancy:
  • The NHS says trazodone "can be used during pregnancy if needed" at the lowest effective dose, and suggests the Bumps website for more detail (NHS).
  • The SmPC notes data from fewer than 200 exposed pregnancies. On basic principles it advises avoiding use in the first trimester, and says newborns should be watched for withdrawal if it is used until delivery.
  • The FDA label says decades of published data "have not identified" a link with major birth defects or miscarriage, but these studies had methodological limits.
• Breastfeeding: trazodone passes into breast milk. The NHS says it is "sometimes used while breastfeeding", but you should check with your doctor first (NHS; FDA).

Dosage and how to take it

Your prescriber sets the dose. The ranges below are the official licensed adult doses, given for information only. They are not a guide to self-dosing.

Sources: UK SmPC (Molipaxin 100 mg capsules); FDA label.

How to take it.

• The NHS advises swallowing tablets or capsules whole with water, once or twice a day, with or just after food. If it makes you sleepy, take it at bedtime (NHS).
• The US label says to take it "shortly after a meal or light snack". Scored tablets can be halved but not chewed or crushed.
• If you miss a dose, take it when you remember, unless it is nearly time for the next one. Never take a double dose.

How long before it works.

• Drowsiness can start with the first doses. The SmPC notes it "usually disappears on continued therapy".
• Mood: for depression, the SmPC warns that improvement "may not occur during the first few weeks or more of treatment". People should be monitored closely during that time.
• Review: NICE recommends reviewing new antidepressant treatment within 2 weeks, or at 1 week for people aged 18–25 or at risk of suicide (NICE NG222).

How to stop. Do not stop suddenly. The NHS says your doctor "will gradually reduce your dose over several weeks or months" (NHS). NICE's general antidepressant advice is to taper step by step, using proportionate reductions (for example 50% of the previous dose) with smaller steps at lower doses, and to watch for withdrawal symptoms (NG222). Any taper should be planned with the prescriber.

Follow the money: who makes it and who funded the evidence

Who makes and sells it

• Originator: Angelini Pharma, headquartered in Rome, Italy, and part of Angelini Industries. It credits its research with "discovering and developing" trazodone and still sells the brand Trittico.
  • Its current company profile reports revenue of "1,2 BN" in 2024 and more than 3,000 employees (Angelini Pharma company profile). An earlier edition gave more than €1 billion of turnover in 2021 (2022 profile).
  • We found no published figure for trazodone's share of that revenue.
• US: the original Desyrel NDA (1981) is now listed under Pragma and is discontinued. Angelini's own US extended-release product, Oleptro (2010), is also discontinued. A newer oral solution, Raldesy, was approved in 2024 (applicant Kamat; label distributed by Validus Pharmaceuticals). US supply is dominated by generics: 33 generic application records on openFDA (openFDA).
• UK: the Molipaxin brand licence is held by Zentiva Pharma UK Limited (London). Generic versions are widely available (SmPC).
• Generic economics: trazodone is off-patent in the UK and US and is sold mainly as generics. The insomnia trials that exist are few, small and mostly old (Cochrane 2018), so its widespread off-label use rests on thin evidence rather than on large modern trials.

Who funded the evidence

• The original licensing trials: the US label says only that efficacy was "established from inpatient and outpatient trials of the trazodone immediate release formulation". We could not verify who sponsored those trials from sources we could access.
• Insomnia trials: the Cochrane review judged 10 of its 23 antidepressant-for-insomnia trials to carry a "high level of sponsorship bias". They were funded by pharmaceutical companies and showed no independent handling of blinding or analysis. This included Walsh 1998, the one trazodone trial the AASM relied on. The Cochrane text does not name the sponsor, so neither do we (Everitt 2018 full text).
• Reviews favourable to trazodone:
  • The 2012 review "Rediscovering trazodone" had an Angelini employee as co-author, and its medical writing "was funded by Angelini, Italy" (Fagiolini 2012).
  • A 2023 expert review recommending trazodone for depression in dementia was written by authors who disclosed consultancy, speaker fees, grants or advisory-board roles with Angelini, among other companies (Fagiolini et al., 2023).
  • These disclosures do not make the reviews wrong. They are narrative expert opinion from people with ties to the originator, and should be weighed accordingly.
• Studies unfavourable to trazodone: the Medicare study linking trazodone to falls was funded by Eisai, whose insomnia drug lemborexant competes with trazodone, and Eisai employees co-authored it (Amari 2022). A competitor's funding is also a conflict.
• Independent reviews:
  • Cochrane (Everitt 2018): a small NIHR grant.
  • Cipriani 2018: NIHR and the Japan Society for the Promotion of Science.
  • De Crescenzo 2022: NIHR. Several of its authors declared fees from Angelini Pharma, and its first author works for Boehringer Ingelheim (De Crescenzo 2022).
  • The Canadian falls cohorts: public and academic money.
• Guideline and regulator funding:
  • The AASM funded its 2017 guideline itself. Its 2023 disclosure shows industry support from makers of other sleep drugs, such as Idorsia and Eisai, but none from trazodone sellers (AASM disclosure).
  • About 77% of the FDA's human-drug review costs in FY2025 came from industry user fees (FDA PDUFA report).
  • NICE is funded mainly by the UK Department of Health and Social Care (NICE annual report 2024/25).
• Integrity events: we did not find any documented legal settlement, retraction or regulator enforcement action specific to trazodone marketing in the sources we checked. This is a statement about our search, not proof that none exists.

Related research

• Sleep: an evidence-based prevention and treatment guide
• Sleep supplements: what the independent evidence shows
• Melatonin: independent evidence review
• Magnesium: independent evidence review
• L-theanine: independent evidence review
• Stress, anxiety and depression prevention guide
• Supplements for stress, anxiety and depression
• St John's wort (serious interaction risk with trazodone)
• Saffron for depression
• Ashwagandha: evidence and safety
• Sibling medicine reviews: mirtazapine, sertraline, amitriptyline, zolpidem, zopiclone

Frequently asked questions

Sources and funding notes

• NHS, Trazodone (page last reviewed 2 July 2026): UK government health service; no commercial funding.
• Summary of Product Characteristics, Molipaxin 100 mg capsules (Zentiva Pharma UK; text revised 4 March 2021): written by the licence holder and approved by the UK regulator.
• FDA-approved label, trazodone hydrochloride tablets (Torrent; DailyMed set ID 1510cf89): accessed via openFDA; licence-holder text approved by the FDA, whose drug review is mostly funded by industry user fees.
• Drugs@FDA records for NDA 018207 (Desyrel), NDA 022411 (Oleptro) and NDA 218637 (Raldesy): US regulator database.
• Sateia et al., AASM Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults, J Clin Sleep Med 2017: US; funded by the AASM. Authors disclosed consulting for Purdue, Merck, Jazz, Janssen, Lundbeck and others; Krystal recused from the suvorexant recommendation.
• Everitt et al., Antidepressants for insomnia in adults, Cochrane 2018: UK; small NIHR SPCR grant and University of Southampton support. Baldwin and Malizia declared past industry grants or fees; the lead author declared none.
• Cipriani et al., Lancet 2018: UK/Japan; NIHR Oxford Health BRC and JSPS. Some co-authors declared fees from antidepressant makers; 78% of the included trials were industry-funded.
• De Crescenzo et al., Lancet 2022: UK/Italy; NIHR-funded. Authors declared fees from Angelini Pharma; the first author is a Boehringer Ingelheim employee; one author leads Janssen-sponsored seltorexant trials.
• Riemann et al., European Insomnia Guideline 2023, J Sleep Res: European Sleep Research Society. Guideline funding and panel declarations were not checked for this article.
• Yi et al., Sleep Med 2018: China/Iran/Canada academic authors. Funding and conflicts not shown in the abstract; not verified.
• Zheng et al., Sci Rep 2022: China; authors declared no competing interests.
• Zhang et al., J Affect Disord 2026: China; authors declared no competing interests.
• McCleery & Sharpley, Pharmacotherapies for sleep disturbances in dementia, Cochrane 2020: UK; Cochrane (commercial sponsorship not permitted).
• Camargos et al., Am J Geriatr Psychiatry 2014: Brazil; university hospital trial. Funding not verified.
• Kheirkhah et al., Naunyn Schmiedebergs Arch Pharmacol 2025: Iran; academic; no competing interests declared.
• Bronskill et al., J Am Geriatr Soc 2018: Canada; ICES and academic authors. Specific funding statement not verified from the abstract.
• Watt et al., CMAJ 2018: Canada; St Michael's Hospital, CIHR, Heart and Stroke Foundation and ICES (Ontario Ministry of Health). One author had an Ontario Ministry grant; no other conflicts.
• Watt et al., Can Geriatr J 2023: Canada; no conflicts declared.
• Harris et al., J Am Med Dir Assoc 2024: Canada; no conflicts declared.
• Herzig et al., Sleep 2021: US academic medical centre. Funding not verified from the abstract.
• Rivasi et al., Drugs Aging 2025: Italy; Fondazione Cassa di Risparmio di Firenze and EU NextGenerationEU; no conflicts.
• Shimizu et al., Neuropsychopharmacol Rep 2022: Japan; single hospital; no conflicts declared.
• Amari et al., BMC Geriatr 2022: US; funded by Eisai (maker of the competing insomnia drug lemborexant); Eisai employees and paid contractors co-authored.
• Wong et al., BMJ 2017: Canada; Canadian Institutes of Health Research; no relevant financial relationships.
• Wong et al., JAMA 2020: US; Harvard fellowship funding. Two authors reported fees from Merck, Eisai or sleep-related companies.
• Bertisch et al., Sleep 2014: US; NHANES analysis. Funding not verified from the abstract.
• Stone et al., BMJ 2022: US; FDA staff authors with Kirsch; "no support from any organization".
• Munkholm, Paludan-Müller & Boesen, BMJ Open 2019: Denmark; re-analysis of Cipriani; no conflicts declared.
• Turner et al., NEJM 2008: US; FDA-data analysis of publication bias. Funding and conflicts not verified.
• Fagiolini et al., "Rediscovering trazodone", CNS Drugs 2012: Italy/Austria; medical writing funded by Angelini; one co-author an Angelini employee.
• Fagiolini et al., Neuropsychiatr Dis Treat 2023: Europe; several authors disclosed Angelini consultancy, grants or advisory roles.
• Cuomo et al., Ann Gen Psychiatry 2026: Italy; narrative review; authors declared no competing interests relevant to the work.
• NICE NG222, Depression in adults (2022) and NICE NG97, Dementia: UK public body, mainly funded by the Department of Health and Social Care (NICE annual report 2024/25).
• Angelini Pharma company profile and 2022 profile: company self-description (Italy); used only for company facts.
• AASM CMSS financial disclosure (2023): the AASM's own disclosure of industry support.
• FDA PDUFA financial report FY2025: US regulator funding data.
• GOV.UK search for "trazodone" (26 September 2026): used to check for MHRA safety communications.

Last reviewed: 26 September 2026. Educational information from Pure City Research, not medical advice. Medicine decisions belong with a qualified prescriber.