Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Trazodone

Antidepressant (SARI) / hypnotic

Brand names: Desyrel

Oral health effects

  • Xerostomia (dry mouth)

    Reduced salivary flow raising caries, candidiasis, and mucosal discomfort risk.

    Clinical management: Hydration, sugar-free gum/xylitol, salivary substitutes, high-fluoride products; reinforce caries prevention.

  • Increased bleeding tendency (impaired platelet function)

    Drugs that block serotonin reuptake reduce platelet serotonin and can increase bleeding (FDA label warning), especially when combined with aspirin, NSAIDs or anticoagulants. Dental studies suggest clinically significant oral bleeding is uncommon.

    Clinical management: No need to stop the antidepressant before scaling or root planing. Expect possible extra gingival bleeding; use local measures (pressure, hemostatic agents) and ask about aspirin, NSAIDs or anticoagulants, which add to the risk. Prefer acetaminophen over NSAIDs when suggesting post-procedure analgesia.

  • Dizziness on standing (orthostatic hypotension)

    Orthostatic hypotension and syncope are a label warning (alpha-1 blockade), with additive effects in patients on antihypertensives.

    Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
  3. Trazodone prescribing information (FDA label) American Health Packaging / DailyMed, 2025.
  4. Systematic Review on Antidepressant Use and Bleeding Risk After Dental Extractions: Evidence Gaps and Clinical Implications. Nemeth A, Rahimi K, Karande S, et al. Journal of clinical medicine, 2025.
  5. Oral Manifestations in Patients in Treatment with Antidepressants: A Systematic Review. Alcázar-Hernández JM, Pecci-Lloret MR, Guerrero-Gironés J. Journal of clinical medicine, 2024.