Role of trazodone in treatment of major depressive disorder: an update

Annals of General Psychiatry

Review

Ana González-Pinto¹  Eduard Vieta²  Andrea Fagiolini³  Allan H. Young⁴  Pedro Morgado⁵  Kamilla Woznica Miskowiak⁶ 

[1] Bioaraba Research Institute, Department of Psychiatry, Araba University Hospital, 01004, Vitoria, Spain;CIBERSAM. University of the Basque Country, Vitoria, Spain;Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain;Department of Molecular and Developmental Medicine, Division of Psychiatry, University of Siena School of Medicine, Viale Bracci 12, 53100, Siena, Italy;Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London Strand, London, UK;South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK;Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal;ICVS/3B’s, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal;Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal;Psychiatric Centre, Copenhagen Affective Disorder Research Centre (CADIC), Rigshospitalet, Copenhagen, Denmark;Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark;Department of Psychology, University of Copenhagen, Copenhagen, Denmark;

关键词: Major depressive disorder;    Trazodone;    Agitation;    Anxiety;    Insomnia;   

DOI  :  10.1186/s12991-023-00465-y

 received in 2023-05-24, accepted in 2023-08-22,  发布年份 2023

来源: Springer

【 摘 要 】

Major depressive disorder (MDD) is the most common mood disorder and a leading cause of disability worldwide. Trazodone, a triazolopyridine serotonin receptor antagonist and reuptake inhibitor (SARI) antidepressant approved for major depressive disorder (MDD) in adults, has established efficacy that is comparable to other available antidepressants, and is effective for a range of depression symptoms, including insomnia, which is one of the most common and bothersome symptoms of depression. Also, trazodone’s pharmacodynamic properties allow it to avoid the side effects of insomnia, anxiety and sexual dysfunction often associated with selective serotonin reuptake inhibitor antidepressants. In this narrative review, we have summarized recent clinical trials and real-world data on trazodone, including the recently introduced once-daily formulation, which has single dose pharmacokinetic properties that maintain effective blood trazodone levels for 24 h, while avoiding concentration peaks associated with side effects. This, combined with a low incidence of weight gain, and sexual dysfunction, may improve adherence to treatment. The most common adverse effects of trazodone are somnolence, headache, dizziness and xerostomia. It has minimal anticholinergic activity but may be associated infrequently with orthostatic hypotension (especially in patients with cardiovascular disease or older adults), QT interval prolongation, cardiac arrhythmias, and rare episodes of priapism. The low liability for activating side effects, the efficacy on symptoms such as insomnia and psychomotor agitation and the rapid onset of action make it useful for many depressed patients, both in monotherapy at nominal dosages of 150–300 mg/day, and in combination with other antidepressants at lower dosages.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1