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Trazodone (Desyrel, Mead-Johnson Pharmaceutical Division)
Drug Intelligence & Clinical Pharmacy
|January 1, 1982
Summary
Trazodone, a novel antidepressant, demonstrates efficacy comparable to traditional tricyclic antidepressants for major depressive episodes. Its favorable side effect profile, including minimal cardiovascular and anticholinergic effects, suggests a beneficial role in depression treatment.
Area of Science:
- Pharmacology
- Psychiatry
- Clinical Medicine
Background:
- Trazodone represents a new class of antidepressants, triazolopyridines.
- Established antidepressants include tricyclic antidepressants (TCAs) like imipramine, desipramine, and amitriptyline.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of trazodone compared to TCAs.
- To explore trazodone's potential benefits in treating anxiety and depression in schizophrenic patients.
Main Methods:
- Clinical trials comparing trazodone to imipramine, desipramine, and amitriptyline.
- Pharmacokinetic studies assessing absorption, peak serum levels, and elimination half-life.
- Analysis of side effect profiles, focusing on anticholinergic and cardiovascular effects.
Main Results:
- Trazodone exhibits efficacy equal to TCAs in treating major depressive episodes.
- Trazodone may offer superior anxiety relief, though further research is needed.
- It has been used successfully in schizophrenic patients without exacerbating psychosis.
- Trazodone selectively blocks serotonin reuptake with minimal impact on norepinephrine or dopamine.
- Trazodone has a biphasic elimination half-life of 4.4 hours (0-10h) and 7.5 hours (10-24h).
- Dosage: 200 mg trazodone is equivalent to 100 mg imipramine; therapeutic range is 200-600 mg/day.
Conclusions:
- Trazodone is clinically effective for depression, matching TCAs.
- Its reduced cardiovascular and anticholinergic side effects make it a potentially safer alternative.
- Trazodone's safety profile, with rare fatal overdose reports, is advantageous.