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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Trazodone is an antidepressant that is also given for its sedative activity. First-trimester exposure to trazodone in 100 infants was not associated with an increased frequency of congenital anomalies (Rosa, personal communication, cited in Briggs et al., 2021), although this study is not peer reviewed. In another investigation that was peer reviewed, 121 women took trazodone or nefazodone during the first trimester. The frequency of congenital anomalies was not increased above that expected in the general population (3.5 percent) (Einarson et al., 2003). Trazodone is a category C drug.
Antidepressant Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
SARIs inhibit 5-HT transporters and show antagonism at 5-HT2A/2C receptors (Pazzagli et al., 1999; Haria et al., 1994) and increase the levels of 5-HT in brain. For example, Trazodone a “second generation” antidepressant drug and used as an alternative to MAOIs and TCAs (Golden et al., 2009). Trazodone is used as a preferred treatment in MDD patients (Golden et al., 2009) and in other conditions including PTSD, bulimia nervosa, and adjustment disorders (Warner et al., 2001; Hudson et al., 1989; Rasavi et al., 1999).
Motility disorders
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Antidepressants may alter visceral pain sensation. Trazodone, a tricyclic-related antidepressant, has been shown, in low doses, to relieve the chest pain of DOS,51 although the manometric effects were inconsistent.
Pharmaceutical management of sexual dysfunction in men on antidepressant therapy
Published in Expert Opinion on Pharmacotherapy, 2022
Ahmed M. Bakr, Amro A. El-Sakka, Ahmed I. El-Sakka
SSRIs are associated with SD in 23% of men [73], and up to 80% of cases in more comprehensive reports [16]. Among SSRIs, some authors reported that paroxetine is associated with the highest risk of SD, about 61% of the patients [43,74]. However, a meta-analysis of data from 970 patients showed that sertraline is associated with a further higher risk (about 80% of patients, odds ratio 27.4 in comparison to placebo) [16]. Fluvoxamine is associated with the lowest risk in-comparison to other SSRI’s (OR = 3.27) [16]. Regarding serotonin-noradrenaline reuptake inhibitors, venlafaxine is associated with slightly less risk of SD than SSRI’s [44]. About 46% of patients on duloxetine developed treatment-induced SD [43]. Trazodone is an important antidepressant in the current practice. It has shown lower risk of SD in comparison with SSRIs, like fluoxetine and sertraline [8,25]. It also showed a role in treating hypoactive sexual desire disorder [75].
Management of insomnia in alcohol use disorder
Published in Expert Opinion on Pharmacotherapy, 2020
Pierre A. Geoffroy, Michel Lejoyeux, Benjamin Rolland
Some antidepressants, such as mirtazapine, trazodone, and amitriptyline, might be of interest for insomnia disorder in AUD patients, because of their histaminergic sedating properties, especially when depressive symptoms exist. These molecules are the most prescribed drugs in the context of AUD [47], but controversies exist suggesting that these sedative molecules may worsen drinking outcomes when they are stopped, as evidenced in a large recent RCT assessing trazodone in 173 patients with AUD and sleep disturbances, and following a detoxification program [47]. Nevertheless, this RCT evaluating trazodone titrated 50 to 150 mg at bedtime during 12 weeks observed an improvement of sleep quality during its administration [47]. This subjective improvement of sleep was also reported in a previous pilot open study [48], as well as another study that used polysomnography and observed that trazodone, titrated from 50 to 200 mg 1 h to bedtime, increased sleep efficiency and the percentage of NREM sleep, while decreasing the number of awakenings and intermittent wake sleep time [49]. Of note, a large retrospective study following residential treatment of 283 patients did not replicate the association between trazodone use at discharge and increased relapse rates at 6 months [23]. However, another retrospective study found that trazodone should be associated with other medications to help maintain abstinence [50].
Unintentional trazodone overdoses in children ≤6 years of age: data from poison center over a period of 16 years
Published in Clinical Toxicology, 2019
Tharwat El Zahran, Brent W. Morgan, Stephanie Hon, Lloyd Herrington, Robert J. Geller
Trazodone (Desyrel) is a triazolopyridine derivative with antidepressant, anxiolytic, and hypnotic effects. It is a weak serotonin reuptake inhibitor. However, its metabolite m-chlorophenyl-piperazine (m-CPP) possesses potent agonist effects on different 5-HT receptor subtypes, with antagonist effect at the peripheral alpha 1 adrenergic receptor [1,2]. Trazodone toxicity can result in drowsiness, ataxia, nausea, vomiting, QT prolongation, hypotension, dry mouth, coma, and death in severe cases [3]. Few fatalities have been reported in literature due to isolated trazodone overdose ingestions [1]. Most fatalities involved concurrent ingestion with other central nervous system depressants [1]. The available dose forms include 25, 50, 100, 150, or 300 mg tablets. It is also available as a 150 mg extended-release tablet named Oleptro™ [4].