Here's my experience that I also posted in another thread.
I've used Trazodone for about 2 years and I highly recommend it. I use it to treat my severe insomnia. I literally can't go to sleep unless I take something - I'm not addicted to downers or anything, my insomnia is really that bad. Over a period of 5+ years I went through Tylenol PM, Melatonin, and every other OC drug you can imagine and not one of them could keep me asleep. Then I moved on to benzo's and other sedatives, which were unsuccessful. Trazodone also helps with my depression.
I've read a lot about people being afraid to try it due to the possible priapism side effect - which is an erection that lasts for hours and won't go away, leading to medical intervention. It does not occur at common dosages and rarely occurs at high doses exceeding 200mg. Most doctors will Rx patients 50mg-100mg nightly, so you DO NOT have to WORRY. I've personally experienced a long, somewhat painful erection at 200mg and wouldn't advise going over that dose.
I started at 50mg. It helped me sleep a little better, but I was always drowsy/groggy the next day and still got up during the night. After about 6 months, I was tired of the drug's hangover effect and felt that it wasn't helping me sleep as well anymore. So about a week ago, my doctor increased the dose to 150mg-200mg a night. After that one experience at 200mg, I've been sticking to 150mg/night.
For me, 150mg is the perfect dose. I actually get refreshing sleep and next-day drowsiness is almost non-existant. I've noticed that the next-day drowsiness decreases as dosage increases. At 50mg I was depressed and moody the next day, but at 150mg the AD effects kick in and I'm in a great mood the entire day. I still have drowsiness after about 8 hours of sleep, but it goes away less than 10 minutes after I wake up.
The only other drug that's worked for me is 2mg-4mg of Klonopin. It took my anxiety away and helped me fall asleep and stay asleep. However, I decided to stop taking it because of its high potential for addiction and rapid development of tolerance. Also, its a pain in the ass to get refilled. You have to go to the doctor's office every month to get it refilled because its a schedule IV drug. Of the two doctors I've seen, both of their first prescriptions were Klonopin. They both said the same thing: "This is the perfect drug for you. Its the safest drug available", and were adamant that I take it, even when I expressed my doubts (tolerance, addiction). But after 2-3 months they were reluctant script refills, even though I wasn't addicted and showed no signs of addiction. At that point I figured it wasn't worth it to try and convince them each month to let me continue a drug that I only tried because they insisted I do so.
Here's a list of what I remember trying, with a Y or N recommendation:
1) Melatonin [OC] - No. Next day drowsiness and tolerance issues.
2) Tylenol PM [OC] - No. Next day drowsiness, did not keep me asleep, not safe to use every night, elevated night urine excretion (Diuresis. Not sure if its a typical side effect).
3) 5-Htp [OC] - No. Not strong enough.
4) Benadryl [OC] - No. Same problems as Tylenol PM.
5) Klonopin 2mg-4mg [Rx, Benzo] - Yes. See above explanation.
6) Lorazepam (Ativan) [Rx, Benzo] - No. Minor anterograde amnesia, not strong enough.
7) Ambien [Rx, Non-benzo hypnotic] - NO. Severe anterograde amnesia, hallucinations. The next morning I wouldn't remember any of what occurred the previous night between the time I took it and the time I fell asleep. During the hour it took to kick in, I'd have lengthy phone conversations with friends. The next day, I'd talk to the same friends and wouldn't remember speaking to them the previous night, even when they reminded me. My memory of that time period was completely blank. Also, when the Ambien started to kick in, I had crazy hallucinations.
8 ) Hydroxyzine HCl 25mg (Atarax) [Rx, Antihistamine] - No. Not strong enough.
9) Zyrtec 10mg [Rx, Antihistamine] - No. Not strong enough. Works great for allergies though.
10) Trazodone 50mg [Rx, Tetracyclic antidepressant] - No. Not strong enough, next-day drowsiness.
11) Trazodone 200mg - NO. A long, painful erection that caused me to wake up multiple times during the night.
12) Trazodone 150mg - YES. Refreshing sleep, barely any drowsiness the following morning, and I'm in a great mood throughout the day.