A combination of trazodone (Desyrel) plus an SSRI (selective serotonin reuptake inhibitor) such as Zoloft or Prozac is often prescribed for depression and anxiety, and your side effects are not unusual. As you point out, it takes a while for your brain chemistry to adjust after starting the medication, and you have just doubled your Zoloft dose.

I have personal experience with both trazodone and various SSRIs (although not Zoloft). Trazodone can cause tiredness and spaciness the next morning (allow time for a full night's sleep if possible), and the euphoria could be a sign of increasing serotonin levels (which would indicate that the Zoloft is having an effect). If the shakiness is a subjective mental feeling (like caffeine jitters), it's bothersome but not worrisome. Like your other described side effects, however, see your prescriber if it persists or becomes too uncomfortable. A switch to a different SSRI can result in much milder side effects.

However, if your shakiness is an actual physical tremor, tell your prescriber as soon as possible, since this could indicate a rare but potentially serious neurologic reaction. Nearly all medications carry some risk, however slight, of serious adverse side effects. In the case of trazodone and the SSRIs, most of these adverse effects can be reversed by stopping the medication. The biggest irreversible reaction is suicide, which is a risk common to all antidepressants, especially in children and teenagers (both Zoloft and trazodone carry "black box" warnings for this reason).

One final note regarding trazodone use in males: Priapism is an uncommon but definitely serious side effect and has been documented after a single 100-mg dose. Any erection lasting more than a few hours is cause for an ER visit, not a celebration.
Source(s):
http://www.rxlist.com/zoloft-drug.htm
http://www.rxlist.com/desyrel-drug.htm
http://psy.psychiatryonline.org/cgi/content/full/46/4/367


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