Trazodone – StatPearls – NCBI Bookshelf

Administration

Trazodone administration is via the oral route. It is available in oral tablets of trazodone hydrochloride 50 mg, 100 mg, 150 mg, and 300 mg in the US. It may be administered after meals to decrease lightheadedness and postural hypotension. Begin with evening administration of 75 mg to 150 mg before bedtime, as a prolonged-release once-a-day administration. This regimen helps optimize its purpose as an antidepressant, eliciting higher compliance.7 The dose may be increased every third day, up to 300 mg per day. The dose may be up to 600 mg per day in hospitalized patients. The dose in the elderly should be down to 100 mg per day. Results of multi-drug regiment studies showed that using citalopram and fluoxetine with trazodone had no significant impact on any alteration of serum level and no increased risk of headache, sedation, or serotonin syndrome.

Studies showed that administering 50 mg to 100 mg per day of trazodone helped nonorganic insomnia due to depressive disorder, with 100 mg dosage as most effective to improve sleep. Trazodone may be available as immediate-release (IR) tablets and, in some countries, prolonged-release tablets, oral drops, and injection solutions.

Pediatric Patients

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There is a boxed warning on an increased risk of suicidal thoughts and behaviors in pediatric patients with antidepressant medication use. However, effectiveness and safety in the pediatric population have not been established for trazodone.

Geriatric Patients

It should be used carefully in elderly patients as serotonergic antidepressants are associated with hyponatremia in elderly patients, who are already at greater risk for this adverse reaction.

Pregnancy Consideration

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Healthcare providers should register pregnant patients with depression in the National Pregnancy Registry for Antidepressants by calling 1-844-405-6185, which monitors pregnancy outcomes in patients exposed to antidepressants during pregnancy. Published literature on trazodone use in pregnant women has not found any associated risks of miscarriage, major congenital disabilities, and adverse maternal or fetal outcomes. The clinical study was conducted on 201 pregnant patients with major depressive disorder history who become euthymic while using antidepressants at the beginning of pregnancy. It showed that patients who discontinued antidepressants during pregnancy have more chances to experience a relapse of major depression than women who continued treatment with antidepressants. Therefore, it is advisable to consider the risk of untreated depression if planning to discontinue or change antidepressant treatment while a patient is pregnant or postpartum

Breastfeeding Consideration

Trazodone is excreted into human milk, and there is a lack of data on its effect on milk production.9 Postmarketing reports have limited data, and it has not identified an association of adverse effects of trazodone use on the breastfed child. Maternal need of trazodone should be accessed along with risk on development and health benefits of breastfeeding to the child. According to the safety scoring system use of trazodone should be used cautiously while breastfeeding, especially infants.

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Hepatic Impairment

Trazodone use is not studied in patients with liver impairment, and it is recommended to use trazodone with caution in this population.

Renal Impairment

Trazodone use is not studied in patients with renal impairment, and it is recommended to use trazodone with caution in this population.

Content Creator Zaid Butt joined Silsala-e-Azeemia in 2004 as student of spirituality. Mr. Zahid Butt is an IT professional, his expertise include “Web/Graphic Designer, GUI, Visualizer and Web Developer” PH: +92-3217244554

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