Trazodone, muscle soreness and tweaks

Medical Q&A [Moderated]
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I’ve been taking 25mg Trazodone for a little over a week. It was prescribed to help me get a bit more sleep (crucial for recovery I know) andb has worked very well. But I noticed a significant drop in strength the first week and managed to tweak my left upper chest, neck and scapula doing my usual seal rows. I read that Trazodone can impact strength in certain ways and increase muscle soreness. I know I have to go into a rehab and recovery cycle anyway, but maybe you can tell me if any of this is unsurprising and if the effect I’m experiencing is likely short term. In case matters, I’m a 61 year rest old male and have been strength training for over a decade - I think I’ve gotten pretty close to the GPP threshold you were going over in a recent podcast (double bodyweight deadlift, etc).

Thank you and have a great Thanksgiving!

-Fred

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Trazodone 25 mg is an extremely low dose; I would not expect it to have any significant direct impact on your strength performance or injury risk.

Can you share the most compelling source you found that claimed a relationship here?

1 Like
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Thank you Dr. Baraki for responding so quickly and so close to Thanksgiving!

Even though 25mg is a small dose, within the first week I’ve definitely had some noticeable side effects which mostly manifested as feeling fatigue and tiredness. I’m getting close to 2 weeks in and fortunately those side effects seem to be going away. But I did have a surprisingly hard training session early on in the first week of taking the medication and somehow tweaked my upper chest, neck and scapula on the left side. That day includes a combination of deadlifts, overhead presses and inclined seal rows, but these were all done at a weight I’ve never had an issue with (for at least the last 6 months that is). So this was a very odd outlier and I think it is most likely correlated to the new medication. I have noticed that I can have a pretty high sensitivity to some medications (but that’s probably too general a statement to mean anything). But I understand this is considered a very low dose.

So the good news is that most of the side effects seem to have gone away, but this muscular tweak I did to myself is taking a bit longer to resolve - which is just annoying as I know I have to start walking the path of rehab and rehabilitation until it goes away. Charlie Dickson helped me out the last time I had a shoulder thing (completely different shoulder thing) and his recent article on shoulder recovery is truly excellent. I’m fortunate I have a reasonably good idea of what I need to do.

As for the source of the information - well, it shouldn’t surprise you too much that this came from Google’s AI/LLM. My prompt was “Can side effects from trazodone leading to minor injuries from weight lifting?” and the way too confident response was:

”Yes, side effects from trazodone could potentially contribute to minor injuries during weight lifting due to effects like dizziness, low blood pressure, muscle weakness, and impaired coordination. These side effects can compromise balance, strength, and reaction time, increasing the risk of accidents.”

When I looked the sources for this inference, they were WebMD, Drugs dot com, and Healthline. Looking at the specific articles, WebMD mentions decreased alertness and coordination, Drugs dot com mentions light headedness, dizziness, unusual tiredness, Healthline mentions weakness under low sodium levels. So I think Google AI/LLM did a lot of heavy lifting here - none of those symptoms are presented with much nuance and the LLM put all these symptoms together and inferred that I could definitely run into issues lifting. I realize using these AI engines for any kind of medical advice is highly problematic…

I also looked at mayoclinic dot org (which I trust because, well, it’s the Mayo clinic) which does mention “unusual tiredness or weakness” under the “More common” side effects. So maybe very early on in adapting to the medication this could interfere with strength training even at a small dose?

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Sure, I figured that the sources you were citing might associate the general sedating effects of trazodone with an increase in injury risk – but not due to any inherent effect of the medicine on the musculoskeletal system itself.

I agree that current AI/LLM use for medical advice is very poor, especially when also being interpreted by laypeople. I’ve run into several issues with this among my patients who were led stray or unnecessarily alarmed by wildly incorrect lab interpretation and advice from LLM tools.

Overall if you feel you’re adapting to the effects of the medicine, and have a good sense of how to manage these aches and tweaks, your prognosis is quite good :slight_smile: Of course, we’re always happy to help via consultation if needed.

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Thank you so much Austin!

You guys do an incredible job on this site - but hey it’s Thanksgiving so I hope you and the BBM crew are having good one and taking some much deserved time off!

I don’t know if this is something that you can weigh in on or not - and to be clear I will contact my doc if things don’t go away let along get worse - but what vaguely worries me is that that while I feel certain the relatively minor soreness I have above the chest and on the clavicle on the left side is due to a tweak from seal rows (because I also feel sore in the left neck muscles and left scapula and the timing is right after training), I also keep thinking “what if this is something more serious?” I kind of want to stick with my hypothesis that this is musculoskeletal, but should I be more worried and seek medical advice?

Thanks!

-Fred