Trazodone, a Review of Clinical Literature and Personal Experience

Agnoli, A.; Gregorio, M. De; Dionísio, Ana

doi:10.1159/000284097

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…Drowsiness is the most common adverse effect of trazodone, with a reported incidence in depressed patients ranging from 5.6 % to 22.5 % (latter estimated from figure) [60, 61]. …”

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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“…Drowsiness is the most common adverse effect of trazodone, with a reported incidence in depressed patients ranging from 5.6 % to 22.5 % (latter estimated from figure) [60, 61]. …”

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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“…In general, trazodone is well-tolerated for treating MDD, with the most common side effects being drowsiness, headache, dizziness, and dry mouth. 72 , 73 Trazodone may be associated with an increased risk of orthostatic hypotension caused by the blockade of adrenergic α1-receptors, 74 especially in older adult patients or those with pre-existing heart disease, 75 , 76 so caution should be exercised when prescribing this medication to patients with dementia. In a retrospective study of the comparative risk of harm associated with the use of zopiclone or trazodone in nursing home residents more than 80% of whom had dementia, 1403 residents received trazodone and 1599 residents received zopiclone.…”

Section: Resultsmentioning

confidence: 99%

Trazodone in the Management of Major Depression Among Elderly Patients with Dementia: A Narrative Review and Clinical Insights

Fagiolini,

González Pinto,

Miskowiak

et al. 2023

NDT

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Objective Major depressive disorder (MDD) often co-occurs with dementia and other neurological disorders, and treatment with antidepressants can improve symptoms, quality of life, and survival in these patients. This narrative review provides an expert opinion about the role and effectiveness of trazodone in the treatment of older adults with MDD and cognitive impairment due to physical illnesses, such as dementia. Results Because of its mechanism of action, trazodone can treat several depression symptoms often seen in people with dementia, including insomnia, agitation, anxiety, cognitive impairment, and irritability. Conclusion Trazodone may be beneficial for patients with dementia or other neurological disorders comorbid with MDD, especially when the clinical picture of depression includes or is comorbid to symptoms of insomnia, irritability, inner tension, anxiety, or psychomotor agitation.

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“…In a review of side effects experienced by 3,047 trazodone-treated patients [23], drowsiness occurred in 9.5% of the patients, followed by dizziness in 6.1 %, and gastrointestinal disor ders in 4.9% (table I). Only 4.5% of the patients complained of dry mouth, and 1.3% experienced blurred vision.…”

Section: Trazodone Well Toleratedmentioning

confidence: 99%

Recent Experience with Trazodone

Lader¹

1987

Psychopathology

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Trazodone is an atypical antidepressant with additional anxiolytic effects. Recent European experience with trazodone is reviewed with respect to antidepressant efficacy, side effects (particularly anticholinergic), anxiolytic actions, cardiotoxicity, overdosage, and use in the elderly. From the data presented in this paper it is concluded that trazodone is effective both as an antidepressant and as an anxiolytic agent, with few side effects and low cardiotoxicity. It is safer than tricyclic antidepressant agents in overdosage and better tolerated in the elderly patient.

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Trazodone, a Review of Clinical Literature and Personal Experience

Cited by 12 publications

References 7 publications

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

Rediscovering Trazodone for the Treatment of Major Depressive Disorder

Trazodone in the Management of Major Depression Among Elderly Patients with Dementia: A Narrative Review and Clinical Insights

Recent Experience with Trazodone

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