Trazodone for Fibromyalgia: Does It Work and What You Need to Know

When you’re living with fibromyalgia, a chronic condition characterized by widespread muscle pain, fatigue, and sleep problems. Also known as fibromyalgia syndrome, it doesn’t show up on blood tests or X-rays—but the pain is very real. Many people turn to trazodone, a sedating antidepressant originally designed for depression but now widely used for sleep and pain. Also known as Desyrel, it’s one of the most prescribed off-label treatments for fibromyalgia. It’s not a cure, but for many, it’s the difference between lying awake all night and getting a few hours of restful sleep.

Why does trazodone help? Fibromyalgia isn’t just about pain—it’s about disrupted sleep cycles. People with the condition often don’t reach deep, restorative sleep stages. Trazodone works by increasing serotonin in the brain, which helps calm overactive nerves and promotes sleep. It also has mild pain-blocking effects, which is why doctors sometimes pair it with other meds like amitriptyline or gabapentin. Unlike stronger sleep aids, trazodone doesn’t carry a high risk of addiction, which makes it a go-to for long-term use. But it’s not perfect. Drowsiness the next day, dry mouth, dizziness, and headaches are common. Some people report feeling foggy or uncoordinated, especially when starting out.

Research on trazodone for fibromyalgia isn’t huge, but what exists is encouraging. A 2020 study in the Journal of Clinical Rheumatology found that patients taking trazodone reported better sleep quality and less morning stiffness compared to those on placebo. Another small trial showed that combining trazodone with pregabalin led to greater pain reduction than either drug alone. It’s not a magic bullet, but for people who struggle with sleep and pain together, it’s often the most practical tool they’ve found.

What’s missing from most discussions? The fact that trazodone doesn’t work for everyone. If you’ve tried it and felt worse—more tired, more dizzy, or even more anxious—you’re not alone. Some people report increased nightmares or vivid dreams. And if you’re on other meds, like SSRIs or SNRIs, you need to be careful. Mixing trazodone with those can raise the risk of serotonin syndrome, a rare but dangerous condition. Always check with your doctor before combining it with anything else.

There are alternatives. Melatonin, low-dose naltrexone, and even cognitive behavioral therapy for insomnia (CBT-I) are gaining traction. But for many, trazodone remains the most accessible and affordable option. It’s generic, covered by most insurance, and often works when other sleep aids fail.

Below, you’ll find real-world insights from patients and doctors about how trazodone fits into fibromyalgia treatment. You’ll see what doses work best, how long it takes to kick in, and which side effects are worth tolerating—and which mean it’s time to try something else.