Worried about heart with taking Trazodone.

[Deepseathree]

I was recently prescribed Trazodone for sleep. I’m apprehensive about taking it though due to heart issue fears. I’m afraid of it causing Long QT syndrome and that leading to torsades de pointes. I have bradycardia which could be a factor in causing those when taking the medication.

[panic_down_under]

I was recently prescribed Trazodone for sleep. I’m apprehensive about taking it though due to heart issue fears. I’m afraid of it causing Long QT syndrome and that leading to torsades de pointes.

A great many medications may affect the QT interval, including quite a few prescribed for cardiovascular disease. Trazodone has only a conditional risk in some circumstances, the lowest risk category. It is unlikely to trigger prolonged QTc on its own. To quote the Credible Meds site which maintains the list of meds that may induce Long QT on behalf of the FDA, meds with a 'conditional risk':

"...are associated with TdP BUT only under certain conditions of their use (e.g. excessive dose, in patients with conditions such as *hypokalemia, or when taken with interacting drugs) OR by creating conditions that facilitate or induce TdP (e.g. by inhibiting metabolism of a QT-prolonging drug or by causing an electrolyte disturbance that induces TdP)."
*low blood potassium levels

The other factor to keep in mind is this finding is based on trazodone doses typically prescribed for anxiety and/or depression, 225-400mg/day (up to 600mg for hospital inpatients), much higher than the 25-75mg usually prescribed for insomnia.

I have bradycardia which could be a factor in causing those when taking the medication.

Have you had a recent EKG/ECG? If so, was there evidence of prolonged QT interval? Also, while an adult resting heart rates of between 60-100 bpm has traditionally been thought to be ideal, cardiologists are increasing coming to the view that it should be in the 50-70 bpm range.

[Deepseathree]

I had one last year, but there wasn’t any mention of a long qt interval. I would assume they would mention it. Thanks for the great detailed response.

[panic_down_under]

I would assume they would mention it.

You would hope so given how many medications, prescription and over-the-counter, also licorice which depletes potassium, may affect the QTc interval.