Postmarketing surveillance by patient self-monitoring: trazodone versus fluoxetine

This article presents incidence estimates and relative risks for a number of adverse clinical events reported by outpatients being treated with either trazodone or fluoxetine. Data were collected via an innovative method of patient self-monitoring. Many of the suggested differences between the two drugs are quite consistent with expected adverse drug reactions documented in both the package insert data for outpatients and with reports in the literature. Findings not so readily anticipated for trazodone, however, include higher relative frequencies for muscle weakness or soreness, skin swelling, and urinary complaints compared with fluoxetine; for fluoxetine, data are presented indicating a higher incidence of various psychologic/psychiatric adverse clinical events, including delusions and hallucinations, aggression, and suicidal ideation. Other possible interpretations of the results are discussed.