II. Indications
- Major Depression (largely replaced by SSRI and SNRI agents)
- Aggressive Behavior (off label)
- Cocaine Withdrawal (off label)
-
Erectile Dysfunction
- See Erectile Dysfunction Management for more effective agents
-
Insomnia
- Not recommended due to low efficacy and adverse effects including Fall Risk
- Sateia (2017) J Clin Sleep Med 13(2): 307-49 [PubMed]
III. Mechanism
- Triazolopyridine derivative
- Unrelated to Tricyclic Antidepressants
- Phenylpiperazine Antidepressant (Serzone prototype)
-
Serotonin Antagonist and Reuptake Inhibitor (SARI)
- Blocks 5-HT-2 postsynaptic receptor
- Low dose: Serotonin receptor Antagonist
- High dose: Serotonin Agonist
- Weaker than SSRIs as a Serotonin reuptake inhibitor
IV. Pharmacokinetics
- Serum Half Life: 4 to 9 hours
- Therapeutic plasma level: 800 to 1600
- Well absorbed
- Extensive hepatic metabolism
V. Safety
- Pregnancy Category C
- Avoid in Lactation
VI. Efficacy
-
Major Depression
- As effective as Fluoxetine, Tricyclic Antidepressants
-
Insomnia
- Decreases nightly awakenings
- Slight improvement on sleep quality
- Does NOT increase sleep time, Sleep Efficiency, Sleep Latency or waking time after sleep onset
- References
VII. Background
VIII. Dosing
-
Insomnia
- Dose: 50 mg orally at bedtime
- Range: 25-100 mg orally at bedtime
- Maximum: 150 mg orally at bedtime
-
Major Depression
- Start: 50 to 150 mg per day in divided doses
- Effective dose: 400 to 600 mg in divided doses
IX. Adverse Effects
- Sedation
- Limits use as an Antidepressant
- Useful in Major Depression with Insomnia
-
Priapism
- See Priapism Management
- Serotonin Syndrome
- Cardiac Arrhythmia
- Decreased Appetite
-
Orthostatic Hypotension (Dizziness)
- Minimize by administering with food
-
Fall Risk
- Increased risk of falls when used for Insomnia
- Fall Risk is higher with Trazodone than with Zolpidem or Benzodiazepines
- Amari (2022) Adv Ther 39(3): 1324-40 [PubMed]
X. Drug Interaction
XI. Toxicity
- Less toxic in Overdose than Tricyclic Antidepressants
- Lower Incidence of Anticholinergic Toxicity
XII. Resources
XIII. References
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Sundberg (1995) Depression Primary Care, PGM, p. 45-57
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Related Studies
trazodone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
TRAZODONE 100 MG TABLET | Generic | $0.07 each |
TRAZODONE 150 MG TABLET | Generic | $0.12 each |
TRAZODONE 300 MG TABLET | Generic | $1.40 each |
TRAZODONE 50 MG TABLET | Generic | $0.04 each |
Ontology: Trazodone (C0040805)
Definition (CHV) | a kind of depression treatment drug |
Definition (CHV) | a kind of depression treatment drug |
Definition (NCI) | A synthetic triazolopyridine derivative, antidepressant and sedative Trazodone acts as a serotonin uptake inhibitor, chemically unrelated to tricyclic, tetracyclic, or other antidepressants. It is effective in patients with schizoaffective disorders; major depressive disorders; and depressive disorders associated with insomnia and anxiety. (NCI04) |
Definition (MSH) | A serotonin uptake inhibitor that is used as an antidepressive agent. It has been shown to be effective in patients with major depressive disorders and other subsets of depressive disorders. It is generally more useful in depressive disorders associated with insomnia and anxiety. This drug does not aggravate psychotic symptoms in patients with schizophrenia or schizoaffective disorders. (From AMA Drug Evaluations Annual, 1994, p309) |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D014196 |
SnomedCT | 372829000, 7336002 |
LNC | LP16297-1, MTHU005053 |
English | Tradozone, Trazodone, 1,2,4-Triazolo(4,3-a)pyridin-3(2H)-one, 2-(3-(4-(3-chlorophenyl)-1-piperazinyl)propyl)-, Searle Brand of Trazodone Hydrochloride, Trazodone [Chemical/Ingredient], tradozone, traZODone, TRAZODONE, trazodone, Trazodone (product), Trazodone (substance) |
Swedish | Trazodon |
Czech | trazodon |
Finnish | Tratsodoni |
Russian | TRAZODON, ТРАЗОДОН |
Japanese | トラゾドン |
Polish | Trazodon |
Spanish | trazodona (producto), trazodona (sustancia), trazodona, Trazodona |
French | Trazodone |
German | Trazodon |
Italian | Trazodone |
Portuguese | Trazodona |
Ontology: Desyrel (C0701914)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D014196 |
English | desyrel, Desyrel, Apothecon Brand of Trazodone Hydrochloride, Bristol Myers Squibb Brand of Trazodone Hydrochloride, Bristol-Myers Squibb Brand of Trazodone Hydrochloride |