Trazodone was developed in Italy in the 1960s and eventually received FDA approval in the United States in 1981 under the brand name Desyrel, marketed as a novel antidepressant with a different side-effect profile than the tricyclic antidepressants that dominated the market at the time.
Over the following decades, as SSRIs and other newer antidepressants became first-line treatments for depression, trazodone's prescribing pattern shifted dramatically — from a primary antidepressant to one of the most common off-label sleep aids in American medicine, a role that now accounts for the large majority of its use.