Trazodone: Common sleep drug is little-known antidepressant

What are the top prescribed drugs for insomnia—Ambien? Lunesta? Yes, but there's another: a nearly 30-year-old generic antidepressant called trazodone, which causes drowsiness as a potentially useful side effect.

Trazodone (Desyrel and generic) was approved by the Food and Drug Administration in 1981 for use as an antidepressant. Though doctors can legally prescribe it for any treatment, the drug does not have an indication for insomnia. There's very little clinical trial evidence on whether it's effective as a sleep aid when there's no accompanying depression, and only modest evidence when there is. Treatment guidelines from the American Academy of Sleep Medicine recommend trazodone for insomnia without depression only when other sleep drugs have failed.

But numerous doctors are convinced, based mainly on their own experience, that trazodone is an appropriate sleep medication for many people, even when there's no depression. Here's why trazodone has become so popular—and what to do if your doctor suggests you try it.