The antidepressant trazodone is currently the second most commonly prescribed treatment for insomnia because of its sedative properties, perceived lack of risk, generic availability, and lack of duration-of-use restrictions. Whereas trazodone is not approved to treat insomnia, relatively few studies actually support its efficacy and safety.

A literature review of clinical trial data concerning trazodone, reported in the Journal of Clinical Psychiatry (April 2005), confirmed the lack of evidence for its effectiveness as an insomnia therapy.A high rate of discontinuation due to adverse effects accompanied the use of trazodone, as did the potential for drug tolerance. The author concluded that risk/benefit considerations may not warrant trazodone use in nondepressed and/or elderly insomnia patients.