Desyrel (generic name: trazodone) can be a wonderful antidepres-sant, although it’s mostly ignored. Research studies show that Desyrel is as effective against depression as any traditional antide-pressant. Desyrel was developed in Italy in the 1960s, and it is in use all over the world. It is one of the antidepressants that helps the body release more serotonin but has little effect on norepinephrine or dopamine.

Desyrel has a so-called heterocyclic structure, which puts it in its own class, different from SSRIs, SNRIs, tricyclics, or any other antidepressant. Desyrel can be combined with many other antidepressants to increase the amount of serotonin that is released into the brain.

Desyrel can also help you sleep at night, and it can even improve the quality of your sleep by normalizing the amount of time you spend in restorative dreaming and deep sleep. This can help you get better rest from the same number of sleep hours. Most people fall asleep within about twenty minutes after taking their Desyrel.

Desyrel works by a different mechanism than the usual sedative sleeping pills, and it can help you get to sleep and stay asleep without becoming addicted. However, it is not licensed for this use. In addition, you will need to work with your doctor to find the right dose for you. If you take too little, you will not fall asleep, and if you take too much, it will be present in your bloodstream when you wake up, and you will feel sleepy.

So what keeps Desyrel from being the world’s most popular anti-depressant? Well, Desyrel has been around for such a long time that it has long lost its aura of newness and modernity. Desyrel’s patent has expired; its generic form is quite inexpensive, and so you will never see any flashy Desyrel promotions on television or the Internet.

You’ll likely start at a low dose of 25 milligrams at bedtime and increase the dose over the course of days to weeks until the Desyrel puts you to sleep at night without leaving you sleepy during the day. This is usually the best starting dose for treating depression. You may end up taking 50 to 100 milligrams at night, although a few patients do better on higher doses up to 300 milligrams.

Patients say that Desyrel takes away their saddest, most negative thoughts and keeps them from overthinking and making mountains out of molehills. Some patients report a slight dulling of emotion. Desyrel is also useful in reducing anxiety, irritability, and anger. You can still get angry while taking Desyrel if you want to, but anger does not flare up as easily.

Patients generally do not experience the typical side effects of tricyclic antidepressants (constipation, dry eyes, etc.) or the typical side effects of SSRI antidepressants (anxiety, edginess, insomnia, or impotence). My patients complain of brief nausea immediately after taking it, but because Desyrel is taken at night, you will probably be asleep and not notice. Some patients have complained of dry mouth or chest congestion in the first few days after starting Desyrel.

Very infrequently, Desyrel can cause a man to have an unusually enlarged penis. This seems to be caused by an exaggeration of the normal process of arousal and erection. Although I have never seen it, textbooks claim that in extreme cases, a few patients’ erections swell out of control. If the penis will not go down, you would need to go straight to the emergency room to get an injection that will deflate it and prevent any damage. Although this is a colorful story, it is estimated that this effect occurs in less than 0.002 percent of cases. On hearing this story, some men were anxious to try Desyrel in hopes of getting some increase, but they were all disappointed.

Desyrel comes in 50, 100, 150, and 300-milligram generic tablets. It reaches a peak in your body about one hour after you swallow it, and it is mostly gone from your body in about a day. Clearance may be slower in elders and overweight patients, so these individuals may need smaller doses.

Desyrel can be very helpful for treating unipolar major depression as well as the insomnia, anxiety, and irritability that often accompany it.