5 Medications Prescribed for Off-label Use


Trazodone (Desyrel)

Trazodone is actually one of the most commonly prescribed off-label sleep medications. PhotoAlto/Frederic Cirou/Getty Images

What It Is: Cyclic antidepressant

What It's Approved to Treat: Depression

Common Off-label Uses: Sleep problems

Trazodone works by stimulating serotonin in the brain, but it's not a selective serotonin reuptake inhibitor (SSRI) like other well-known antidepressants such as fluoxetine (Prozac). The drug was originally approved by the FDA in 1981 to treat depression, but because it causes drowsiness, it's actually become one of the most commonly used sleep medications. The drug still isn't FDA-approved to treat insomnia, however, and not much research has been done to support its long-term effectiveness or safety.

Because of the intense drowsiness it can cause, trazodone isn't commonly prescribed to treat depression alone anymore, but doctors continue to prescribe it as a lower-cost alternative to sleep medications like zolpidem (Ambien) and eszopiclone (Lunesta).

Many experts believe trazodone is safer than traditional sleep medications and less likely to result in impaired abilities or dependence, but the medication does have its own risks: It's more likely than newer sleep medications to leave users feeling drowsy the next day, and it can cause abnormally low blood pressure, dizziness, or fainting, especially in elderly patients [source: Consumer Reports].