I guess at least she's cautious, but I've never had a pdoc want an EKG before prescribing Trazodone. I'm not 100% sure, but it is one of the safer drugs to take out there, and you are able to stop it without tapering (at least I was). The problem with Trazodone (for me anyway) was that the amount I needed to sleep often left me feeling hungover in the morning. I'd only start feeling normal around 3-4 PM. It used to be used as an anti-depressant, but that is not common anymore as it is generally too sedating at the effective anti-depressant doses for most people. But I was able to use a smaller amount of it with hydroxyzine. I needed hydroxyzine to fall asleep, trazodone to stay asleep. And my old pdoc would remind me even though I was not taking a therapeutic dosage for depression, trazodone would still have some anti-depressant properties that can help with the lows of depression. I can't take more than 100 mg of trazodone a night without the hungover feeling. I looked it up, and I took 50-100 mg of trazodone a night with 50-75 mg of hydroxyzine for sleep. I did better on that. Otherwise, it took like 300-400 mg of trazodone for me to sleep, and I was just zombified. I'd ask to go back on the trazodone/hydroxyzine mix rather than the straight trazodone for sleep if the pdoc determines Clonidine is the culprit of my latest hypomania. But in this case I'm lucky; he is a colleague of my retiring pdoc, so he knows her and that she is very highly regarded in the field. Plus, the office staff can look up the old dosages, no problem. I switched to the Clonidine because for some reason, the trazodone/hydroxyzine mix just stopped working for sleep during a hypomanic phase, and that was the point at which I started seeing my current pdoc. So maybe it would work for me again; it could have just been the mania of the episode escalating with more & more nights of no sleep.

If you are prescribed trazodone, it always took 1-2 hr to take effect for me, but the hydroxyzine worked much faster (sleep with it doesn't last as long though).

It's funny though. Every single pdoc I've been to hands out trazodone like candy. I've never had to so much as ask for it. I don't know, maybe it's because I've been on it ever since I started psych treatment.