Pharm
Desyrel
search
Desyrel
, Trazodone
Indications
Insomnia
(as adjunct to
SSRI
)
Impotence
See
Impotence Management
for more effective agents
Mechanism
Triazolopyridine derivative
Unrelated to
Tricyclic Antidepressant
s
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
SSRI
s as a
Serotonin
reuptake inhibitor
Pharmacokinetics
Serum Half Life: 4 to 9 hours
Therapeutic plasma level: 800 to 1600
Efficacy
Major Depression
As effective as
Fluoxetine
,
Tricyclic Antidepressant
s
Background
Cost: $34 per month (generic)
Dosing
Sleep
Dose: 25-100 mg PO qhs
Average: 50 mg PO qhs
Major Depression
Start: 50 to 150 mg per day in divided doses
Effective dose: 400 to 600 mg in divided doses
Adverse Effects
Sedation
Limits use as an
Antidepressant
Useful in
Major Depression
with
Insomnia
Priapism
See
Priapism
Management
Serotonin Syndrome
Cardiac Arrhythmia
Orthostatic Hypotension
(
Dizziness
)
Minimize by administering with food
Drug Interaction
Increased serum
Digoxin
level
Increased
Phenytoin
level
Toxicity
Less toxic in
Overdose
than
Tricyclic Antidepressant
s
Lower
Incidence
of
Anticholinergic Toxicity
References
Sundberg (1995) Depression Primary Care, PGM, p. 45-57
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