Treating depression in clinical practice: new insights on the multidisciplinary use of trazodone

Frontiers in Psychiatry

Psychiatry

Carmine Tomasetti¹  Francesca Neviani²  Alessandro Pirani³  Umberto Albert⁴  Orazio Zanetti⁵  Daiana Taddeo⁶  Camillo Marra⁷  Giuseppe Maina⁸ 

[1] ASL Teramo, Department of Mental Health of Teramo, Alzheimer Centre of Giulianova, Teramo, Italy;Center for Cognitive Disorders and Dementia, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy;Center for Cognitive Disorders and Dementia, Health County of Ferrara, Ferrara, Italy;Alzheimer’s Association “Francesco Mazzuca”, Ferrara, Italy;Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy;Azienda Sanitaria Integrata Giuliano-Isontina—ASUGI, UCO Clinica Psichiatrica, Trieste, Italy;IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy;Italian College of General Practitioners and Primary Care, Florence, Italy;Neurology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy;Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy;San Luigi Gonzaga Hospital, University of Turin, Turin, Italy;Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Turin, Italy;

关键词: serotonin antagonist/reuptake inhibitors;    comorbidity;    psychiatric disorders;    neurological disorders;    dementia;    primary care;   

DOI  :  10.3389/fpsyt.2023.1207621

 received in 2023-04-17, accepted in 2023-07-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

Depression is estimated to be a leading contributor to the global mental health-related burden. The determinants of this huge prevalence lie in the fact that depressive symptoms may be comorbid in a wide variety of disorders, thus complicating and exacerbating their clinical framework. This makes the treatment of depressive symptoms difficult, since many pharmacological interactions should be considered by physicians planning therapy. Hence, depression still represents a challenge for both psychiatrists and other clinicians, in terms of its high rates of relapse and resistance despite well-established protocols. It is also complicated by the well-known latency in its complete response to current antidepressant treatments. In this context, the search for new strategies regarding antidepressant treatment is mandatory. Revising the use of “old” pharmacotherapies by considering their specific features may help to perfecting the treatment of depression, both in its standalone psychiatric manifestation and in the framework of other clinical conditions. Using a nominal group technique approach, the results of a consensus of expert physicians regarding the possible use of trazodone as a valuable strategy for addressing the “real world” unmet needs of depression treatment in different fields (psychiatry, primary care, neurology and geriatrics) is herein provided. This idea is based on the unique characteristics of this drug which delivers a more rapid antidepressant action as compared to other selective serotonin reuptake inhibitors. It also has pharmacodynamic malleability (i.e., the possibility of exerting different effects on depressive symptoms at different dosages) and pharmacokinetic tolerability (i.e., the possibility of being used as an add-on to other antidepressants with scarce interaction and achieving complimentary effects) when used in the milieu of other drugs in treating comorbid depressive symptoms. Moreover, the large number of formulations available permits finite dosage adjustments, and the use of trazodone for specific pathologies, such as dysphagia. Therefore, although additional studies exploring the real-world conditions of antidepressant treatment are warranted, experts agree on the idea that depressive disorder, in both its standalone and its comorbid manifestations, may surely take advantage of the particular characteristics of trazodone, thus attempting to reach the greatest effectiveness in different contexts.

【 授权许可】

Unknown   
Copyright © 2023 Albert, Tomasetti, Marra, Neviani, Pirani, Taddeo, Zanetti and Maina.