Combined Treatment with Haloperidol and Trazodone in Patients with Tic Disorders

Saccomani, L.; Rizzo, Pierpaolo; Nobili, Lino

doi:10.1089/cap.2000.10.307

Cited by 10 publications

(4 citation statements)

References 1 publication

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“…To date, there are no data on the use of trazodone in children and adolescents with MDD. In a small open-label study of ten children with chronic tic and Tourette’s syndrome, the combination of haloperidol and trazodone was shown to improve clinical symptoms effectively [57]. At study end, the Yale Global Tic Severity Scale score was significantly reduced from baseline, and no adverse effects were reported.…”

Section: Efficacy and Tolerability Of Trazodone In Mddmentioning

confidence: 99%

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

et al. 2012

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Trazodone is a triazolopyridine derivative that belongs to the class of serotonin receptor antagonists and reuptake inhibitors (SARIs). The drug is approved and marketed in several countries worldwide for the treatment of major depressive disorder (MDD) in adult patients. In clinical studies, trazodone has demonstrated comparable antidepressant activity to other drug classes, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin–noradrenaline (norepinephrine) reuptake inhibitors (SNRIs). Moreover, the SARI action of trazodone may overcome the tolerability issues that are often associated with second-generation antidepressants such as SSRIs (i.e. insomnia, anxiety and sexual dysfunction). Recent focus has been placed on the development of a new prolonged-release once-a-day formulation of trazodone (TzCOAD), which may provide improved tolerability over the conventional immediate-release formulation of trazodone. Clinical studies have led to the recent approval in the USA of TzCOAD (as Oleptro™; Angelini Labopharm LLC, Princeton, NJ, USA), which may see resurgence of interest in the drug for the management of patients with MDD. Although trazodone is approved for the treatment of depression, evidence supports the use of low-dose trazodone as an off-label hypnotic for the treatment of sleep disorders in patients with MDD. The most common adverse effects reported with trazodone are drowsiness (somnolence/sedation), headache, dizziness and dry mouth. Other events reported, albeit with low incidence, include orthostatic hypotension (particularly in elderly patients or those with heart disease), minimal anticholinergic activity, corrected QT interval prolongation and torsade de pointes, cardiac arrhythmias, and rare occurrences of priapism and suicidal ideation. Overall, trazodone is an effective and well tolerated antidepressant (SARI) with an important role in the current treatment of MDD both as monotherapy and as part of a combination strategy. Trazodone is effective in controlling a wide range of symptoms of depression, while avoiding the negative effects on sleep seen with SSRI antidepressants. The recently approved prolonged-release formulation should provide further optimization of this antidepressant and may be useful for enabling an appropriate therapeutic dose to be administered with improved patient compliance.

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Section: Efficacy and Tolerability Of Trazodone In Mddmentioning

confidence: 99%

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

et al. 2012

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“…TRA is commonly prescribed to pediatric patients - not only for insomnia [59] and mood disorders [60], [61], but also for migraine prophylaxis [62] and treatment of behavior disorders (such as tic disorders [63], aggressive behavior disorders [64], and attention disorders [65]). Thus our current findings raise important questions regarding the consequences of long-term use of these drugs in pediatric populations.…”

Section: Discussionmentioning

confidence: 99%

The Sedating Antidepressant Trazodone Impairs Sleep-Dependent Cortical Plasticity

et al. 2009

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BackgroundRecent findings indicate that certain classes of hypnotics that target GABAA receptors impair sleep-dependent brain plasticity. However, the effects of hypnotics acting at monoamine receptors (e.g., the antidepressant trazodone) on this process are unknown. We therefore assessed the effects of commonly-prescribed medications for the treatment of insomnia (trazodone and the non-benzodiazepine GABAA receptor agonists zaleplon and eszopiclone) in a canonical model of sleep-dependent, in vivo synaptic plasticity in the primary visual cortex (V1) known as ocular dominance plasticity.Methodology/Principal FindingsAfter a 6-h baseline period of sleep/wake polysomnographic recording, cats underwent 6 h of continuous waking combined with monocular deprivation (MD) to trigger synaptic remodeling. Cats subsequently received an i.p. injection of either vehicle, trazodone (10 mg/kg), zaleplon (10 mg/kg), or eszopiclone (1–10 mg/kg), and were allowed an 8-h period of post-MD sleep before ocular dominance plasticity was assessed. We found that while zaleplon and eszopiclone had profound effects on sleeping cortical electroencephalographic (EEG) activity, only trazodone (which did not alter EEG activity) significantly impaired sleep-dependent consolidation of ocular dominance plasticity. This was associated with deficits in both the normal depression of V1 neuronal responses to deprived-eye stimulation, and potentiation of responses to non-deprived eye stimulation, which accompany ocular dominance plasticity.Conclusions/SignificanceTaken together, our data suggest that the monoamine receptors targeted by trazodone play an important role in sleep-dependent consolidation of synaptic plasticity. They also demonstrate that changes in sleep architecture are not necessarily reliable predictors of how hypnotics affect sleep-dependent neural functions.

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“…Various drugs have been evaluated for the treatment of patients with Tourette syndrome [5][6][7][8][9][10][11][12][13][14][15][16][31][32][33][34][35][36][37]. Although haloperidol improves symptoms in the majority of patients [5], potential side effects such as tardive dyskinesia are of concern.…”

Section: Discussionmentioning

confidence: 99%

“…Drugs indicated for the treatment of Tourette syndrome include haloperidol and pimozide [5][6][7][8]; however, these drugs are associated with troubling side effects that can lead to discontinuation [9]. Antipsychotic drugs [6,[10][11][12][13][14][15], dopamine antagonists [16], and botulinum toxin type A [17] are being evaluated for the treatment of tics, but no single agent has emerged as an ideal therapy.…”

Section: Introductionmentioning

confidence: 99%

Long-term use of levetiracetam to treat tics in children and adolescents with Tourette syndrome

2015

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Tics are a common disorder in children. Some available drugs have unacceptable side effects, and thus alternative treatments are needed. Levetiracetam is an antiepileptic drug reported to be useful for the treatment of tics. Patients age 18 years and younger with tics and Tourette syndrome were enrolled in this prospective, open-label study. Seventy patients were treated with levetiracetam as monotherapy for four years. The initial dose of levetiracetam was 250 mg/day. The dose was titrated over three weeks to 1,000 to 2,000 mg/day. Clinical outcomes were assessed with the Clinical Global Impression Scale, Yale Global Tic Severity Scale, Revised Conners? Parent Rating Scale, and Revised Conners? Teacher Rating Scale. After four years of treatment with levetiracetam, all 70 patients showed some improvements based on the scales used. A total of 49 patients improved with regard to behavior and school performance. Levetiracetam was generally well tolerated. Despite the limitations of open-label studies, these results suggest that levetiracetam may be useful in treating tics in children and adolescents. Given its established safety profile, levetiracetam is a candidate for further study.

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Combined Treatment with Haloperidol and Trazodone in Patients with Tic Disorders

Cited by 10 publications

References 1 publication

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

The Sedating Antidepressant Trazodone Impairs Sleep-Dependent Cortical Plasticity

Long-term use of levetiracetam to treat tics in children and adolescents with Tourette syndrome

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