TRAZODONE

It is not a tricyclic compound; a highly selective but relatively less potent 5-HT uptake inhibitor; has weak anticholinergic action and low propensity to cause cardiac arrhythmias-may be peferred in elderly and glaucomatous patients. Inappropriate, prolonged and painful penile erection and impotence has been reported. Its sedative property is useful against concomitant anxiety & is less likely to cause convulsions or cardiotoxicity in overdose. Trazodone is an oral medication commonly prescribed for depression, anxiety, and insomnia. It is classified as a serotonin antagonist and reuptake inhibitor (SARI), which means it works by affecting the levels of serotonin in the brain to improve mood and promote relaxation and sleep.

Indications

Depression, depression associated with anxiety & insomnia, pseudodementia of depression origin, secondary depression in schizophrenia, depression in chronic alcoholism. Obsessive compulsive neurosis & phobic states are also improved.

Dosage

50-200 mg/day. Initially 50 mg at bed time for first 3 days. Then increase to 100 mg at bed time, if well tolerated, give additional 50 mg in div. doses during day time.Usual total daily dose:3 mg/kg bodywt.

Contra-Indications

-Trazodone should not be used in individuals who are hypersensitive to the drug. -It is contraindicated in individuals taking monoamine oxidase inhibitors (MAOIs) due to the risk of serious drug interactions. -It should be used with caution in patients with a history of cardiac arrhythmias.

Special Precautions

Concomitant use of C.N.S. depressants, alcohol & muscle relaxants. Hepatic or renal impairment. Epilepsy.Cardiovascular disorders.Prolonged & painful penile erection & impotence. Paediatrics: Safety not established. Pregnancy & Lactation:Unsafe. Elderly: Dose should be reduced.

Side Effects

-Common side effects include drowsiness, dizziness, dry mouth, headache, and gastrointestinal disturbances. -Less common side effects may include blurred vision, sweating, tremor, or fatigue. -Serious side effects such as arrhythmias, serotonin syndrome, and priapism require medical attention.

Drug Interactions

Increases serum digoxin and phenytoin levels, sedative effect enhanced by alcohol and other CNS depressants, MAOIs should not be given within 1 weak of discontinuing trazodone.