Furthermore, depression can aggravate the chronic disease and vice versa could be exacerbated by the chronic disease itself. In patients with one or more chronic illnesses or disabling conditions, secondary depression can be induced by pharmacological treatments 13. In the elderly population, the risk of depression is high 12. In such context, trazodone can represent an efficacious treatment for the geriatric population. Recent studies investigated the efficacy of particular antidepressants in improving symptoms for specific phenotypical profiles, thus showing how the selection of the best drug for a given cluster could be the new personalised approach for depression 11. Furthermore, the transdiagnostic determinants and the DSM-5 specifiers (e.g., with anxious distress or with psychotic features) generate a much higher number of clinically relevant profiles 9, 10. Therefore, up to 16,400 possible symptom profiles can generate a diagnosis of MDD 8. At least one of the symptoms should be either depressed mood or anhedonia 7.Īll DSM criterion symptoms, except depressed mood, comprise at least two sub-symptoms, and three of the criterion symptoms (sleep, weight/appetite, psychomotor) can be met by either increases or decreases. To diagnose MDD, an individual must be experiencing five or more symptoms ( Tab. The peculiar multifunctional pharmacological profile of trazodone explains its efficacy to improve Major Depressive Disease (MDD), a very heterogeneous condition often associated with anxiety, insomnia, agitation, nervousness, or irritability 2, 4-6. Trazodone is indicated for the treatment of depression and has been shown efficacious in reducing most symptoms associated with depression 1-3. The great availability of formulations allows to personalise trazodone administration according to patient profile characteristics. Orthostatic hypotension and headache are relatively common side effects. Somnolence/sedation, dizziness, consti- pation, and blurred vision are common side effects with an incidence slightly greater than 5%. In patients with Alzheimer’s disease or frontotemporal dementia, trazodone can help to handle behavioural symptoms, also acting as a putative neuroprotective agent. In patients with neurological conditions, trazodone helps to treat anxiety-depres- sive symptoms. It can help to improve insomnia and anxiety without resorting to benzodiazepines. In elderly patients, trazodone has reported excellent results, keeping high-quality standards for safety and tolerability. The maximum daily dose should not exceed 300 mg/day, split over two administra- tions across the day. formula- tion, and 50-100 mg for the P.R. In elderly patients, trazodone may be administered at very low dosages (25-50 mg/day for I.R. For COAD formulation, the starting recom- mended dose is 150 mg once daily. The initial dose of trazodone should range from 75 to 100 mg/day. The aim of this review was to summarise the pharmacological proper- ties of trazodone in improving depressive symptoms in elderly patients and in patients with neurological comorbidities, for whom secondary depression is often present.įive different pharmaceutical formulations of trazodone are available: intravenous or intramuscular liquid solution, immediate-release tablets (I.R.), oral drops, prolonged-release tablets (P.R.), and extended-release Contramid® tablets (COAD). Trazodone is indicated for the treatment of Major Depressive Disorder (MDD), often associated with anxiety, insomnia, agitation, nervousness, or irritability. Original investigation - until March 2020 Translational Research in Gerontology and Geriatrics - Hypothesis Papers Translational Research in Gerontology and Geriatrics - Clinical Guidelines Translational Research in Gerontology and Geriatrics - Reviews Translational Research in Gerontology and Geriatrics - Short Communications Translational Research in Gerontology and Geriatrics - Original Investigations Geriatrics and Gerontology Elsewhere - Hypothesis papers Geriatrics and Gerontology Elsewhere - Commentaries Geriatrics and Gerontology Elsewhere - Editorials Clinical Geriatrics - Original InvestigationsĬlinical Geriatrics - Short CommunicationsĬlinical Observations in Geriatrics - Clinical Experiences and Case Reports
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