Trazodone Is Only Slightly Faster Than Fluoxetine in Relieving Insomnia in Adolescents with Depressive Disorders

Kallepalli, B. Raju; Bhatara, Vinod S.; Fogas, Bruce S.; Tervo, Raymond C.; Misra, Lalith K.

doi:10.1089/cap.1997.7.97

Cited by 35 publications

(9 citation statements)

References 19 publications

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“…The effectiveness of trazodone was further established in the 1990s both in patients with primary insomnia [61, 83] and in those with insomnia associated with a depressive state [84–86]. The results of comparative clinical studies evaluating the use of trazodone as a hypnotic agent for insomnia in patients with depression showed that it was at least as effective as SSRIs (fluoxetine) [37, 87] and MAOIs (brofaromine) [88] in relieving symptoms of insomnia.…”

Section: Use Of Trazodone In Other Psychiatric Disordersmentioning

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: Use Of Trazodone In Other Psychiatric Disordersmentioning

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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“…Trazodone helps depressed insomniacs more than fluoxetine during the first week of administration, but by the second week of administration, there is no signifi- 34 In direct comparison, zolpidem was more effective than trazodone initially, as well as after the first week of treatment. 35 Marketed since 1993, the most commonly prescribed sleep agents are the selective BDZ receptor agonists zolpidem and zaleplon.…”

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confidence: 95%

Treatment of Primary Insomnia

Ringdahl¹,

Pereira²,

Delzell³

2004

The Journal of the American Board of Family Medicine

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Ten percent to 40% of adults have intermittent insomnia, and 15% have long-term sleep difficulties. This article provides a review of the classification, differential diagnosis, and treatment options available for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Articles were selected based on their relevance to the topic. Evaluation of insomnia includes a careful sleep history, review of medical history, review of medication use (including over-the-counter and herbal medications), family history, and screening for depression, anxiety, and substance abuse. Population-based studies estimate that 10% to 40% of American adults have intermittent insomnia; 10% to 15% have long-term sleep difficulties. 2Insomnia has been associated with decreases in work performance and increases in motor vehicle accidents and hospitalization rates.3 Cost estimates for lost productivity and insomnia-related accidents exceed $100 billion per year. 4 The purpose of this review is to provide a current review of the classification, the differential diagnosis, and treatment options for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Abstracts were reviewed by 2 of the authors (ENR, SLP). Articles were then selected based on relevance to the topical review.

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Trazodone Is Only Slightly Faster Than Fluoxetine in Relieving Insomnia in Adolescents with Depressive Disorders

Cited by 35 publications

References 19 publications

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

Treatment of Primary Insomnia

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