Overview of USA controlled trials of trazodone in clinical depression

Trazodone's unique chemical structure reflects its distinct pharmacologic profile. Its antidepressant efficacy is postulated to occur through serotonin reuptake inhibition. It has little effect on other neurotransmitter systems. In the United States it has been studied in several double-blind trials which compared it to standard antidepressants and placebo. Both in- and outpatients spanning a spectrum of age and diagnoses have been studied. Trazodone has been shown to be at least as effective as standard antidepressants. There are few anticholinergic or cardiovascular side effects. Adverse reactions include drowsiness, dizziness, headache, nausea and rarely, priapism. It is relatively safe in overdose. Trazodone deserves special consideration in the treatment of patients with depression accompanied by marked agitation, anxiety, and insomnia, as well as those unable to tolerate anticholinergic side effects.