Can Trazodone Cause Vertigo?: Separating Fact from Common Dizziness Side Effects

October 10, 2025 •

2 min read

Dizziness is a common side effect of trazodone, affecting up to 28% of patients in some reports, and true vertigo has also been documented as an uncommon adverse effect. Understanding the specific cause of your symptoms is crucial for effective management and safety. This article explores the pharmacological basis and risk factors behind whether can trazodone cause vertigo.

Quick Summary

Trazodone can cause common side effects like dizziness and lightheadedness, primarily due to orthostatic hypotension, which is a drop in blood pressure upon standing. Although true vertigo is less common, it is a reported adverse reaction. Risk factors like age, dose, and other medications can increase susceptibility to these balance disturbances, which can often be managed with simple lifestyle adjustments or require medical consultation if severe.

Key Points

Common vs. Uncommon: While dizziness from orthostatic hypotension is a common side effect, true spinning vertigo is a rarer adverse reaction of trazodone.
Orthostatic Hypotension: Trazodone's alpha-adrenergic blocking action can cause a drop in blood pressure when standing, leading to lightheadedness and unsteadiness.
Dose-Dependent Risk: The intensity of dizziness and lightheadedness is often dependent on the dose of trazodone, with higher doses carrying a greater risk.
Older Adults at Higher Risk: Elderly patients are particularly susceptible to trazodone's hypotensive and sedative effects, increasing their risk of falls.
Management Strategies: Mitigate dizziness by rising slowly, staying hydrated, taking the medication with food, and avoiding alcohol.
When to Call a Doctor: Seek medical attention if you experience fainting, true vertigo, irregular heartbeats, or if the dizziness is severe or persistent.

Understanding the Connection Between Trazodone and Balance Issues

Trazodone is an atypical antidepressant often prescribed for major depressive disorder and, off-label, for insomnia. While its primary action involves modulating serotonin, it also possesses antagonistic properties that can affect the cardiovascular and nervous systems, leading to a range of side effects, including balance issues. It is important to distinguish between general dizziness and true vertigo, as this can help in understanding the potential cause and course of action.

The Role of Orthostatic Hypotension

A common cause of feeling off-balance while taking trazodone is orthostatic hypotension, a sudden drop in blood pressure upon standing. This occurs because trazodone blocks alpha-1 adrenergic receptors, preventing proper blood vessel constriction when changing posture. This can result in lightheadedness or unsteadiness, distinct from the spinning sensation of true vertigo.

Trazodone's Effect on the Central Nervous System

Trazodone can also cause sedation by blocking histamine H1 receptors. This drowsiness can affect concentration, coordination, and balance, increasing the risk of falls, particularly in older adults.

Differentiating Trazodone-Induced Dizziness from True Vertigo

It is crucial to distinguish between general dizziness and true vertigo. While dizziness is a known side effect of trazodone, true vertigo is less common.


Symptom	Dizziness (Common with Trazodone)	True Vertigo (Uncommon with Trazodone)
Primary Sensation	Feeling lightheaded, woozy, or unsteady; like you might faint.	A false sensation of movement, such as spinning or whirling, either of yourself or your surroundings.
Associated Symptoms	Weakness, blurred vision, or confusion, especially after changing position.	Nausea, vomiting, loss of balance, and involuntary eye movements (nystagmus).
Triggers	Often triggered by a change in posture, like standing up quickly.	Can be triggered by head movements or inner ear issues, not solely by standing.
Primary Cause	Orthostatic hypotension and sedative effects.	Asymmetric involvement of the vestibular system, which can be caused by various drugs in some cases.

Factors that Increase the Risk of Balance Issues

Several factors can increase the risk of dizziness or vertigo with trazodone, including dosage and age. Older adults are at a higher risk. Other medications, such as benzodiazepines, alcohol, or other antihypertensives, can also increase the risk.

How to Manage Trazodone-Induced Dizziness

Strategies to manage dizziness include changing positions slowly, taking the medication with food, staying hydrated, adjusting the dosing schedule, and avoiding alcohol.

When to Seek Medical Attention

Contact your healthcare provider if you experience persistent or severe lightheadedness, fainting, true vertigo with nausea or vomiting, a fast or irregular heartbeat, or symptoms of serotonin syndrome.

Conclusion

In conclusion, can trazodone cause vertigo? Yes, though it's uncommon. Dizziness and lightheadedness are more frequent, primarily due to orthostatic hypotension and sedative effects. Risk factors include age, dose, and other medications. Management strategies like rising slowly and taking medication with food can help. Seek medical advice for severe or true vertigo symptoms. For additional authoritative information, you may refer to sources like the National Institutes of Health (NIH).

Frequently Asked Questions

Trazodone commonly causes dizziness, which is a feeling of unsteadiness or lightheadedness, often due to a drop in blood pressure when standing up. True vertigo, which is rarer with trazodone, is the specific sensation of you or your surroundings spinning or moving.

Yes, trazodone can cause orthostatic hypotension, a condition where your blood pressure suddenly drops when you stand up. This is a well-documented side effect caused by its alpha-1 adrenergic receptor blocking properties.

To help prevent dizziness, rise slowly when changing from a sitting or lying position to standing. Taking trazodone with food can also slow its absorption and reduce side effects like lightheadedness. Maintaining good hydration is also recommended.

You should not stop taking trazodone suddenly without consulting your doctor. Abruptly stopping can cause withdrawal symptoms, including dizziness. Discuss bothersome side effects with your healthcare provider, who may adjust your dose or recommend management strategies.

If you experience severe dizziness, fainting, a spinning sensation, or irregular heartbeats, you should seek immediate medical attention. These symptoms could indicate a more serious issue or an adverse reaction requiring prompt evaluation.

Yes, the risk and severity of orthostatic hypotension and dizziness are often related to the dosage of trazodone. Higher doses may increase the likelihood and intensity of these side effects.

Yes, older adults are at a higher risk of experiencing side effects like dizziness and low blood pressure from trazodone. A healthcare provider will often start at a lower dose and monitor closely to minimize these risks.