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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effectiveness of trazodone was assessed over a 4-week period under double-blind conditions. Twenty-eight inpatients with a diagnosis of endogenous depression received either trazodone, imipramine, or placebo. Trazodone was significantly better than placebo and frequently better than imipramine according to analyses of the results of the Hamilton Psychiatric Scale for Depression, severity of illness and clinical global improvement ratings, and the Global Ward Behavior Scale. Significant improvement was evident in the trazodone group by the end of the first week of therapy, particularly in those symptoms associated with depression and accompanying anxiety. There were fewer side effects with trazodone than with imipramine.
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PMID:Trazodone, a new antidepressant: efficacy and safety in endogenous depression. 38 4

A 6-week placebo-controlled trial evaluated the efficacy of trazodone hydrochloride for the relief of chronic low back pain. Forty-two subjects (22 trazodone, 20 placebo) with a 20.3-year average history of back pain were titrated to an average dose of trazodone 201 mg or placebo 238 mg and evaluated daily on a Visual Analogue Scale of pain intensity, at 2-week intervals on an observer rating of pain behavior while walking, and before and after the trial on the Beck Depression Inventory, the Sickness Impact Profile, and a solid state microcomputer (Vitalog) that measured physical activity. Trazodone blood levels and urine toxicology screens were also obtained. There were no significant differences between groups in treatment effect. The results of this study require confirmation by longer trials with larger, less chronic, more homogeneous samples at higher doses with follow-up assessments.
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PMID:A randomized, double-blind, placebo-controlled trial of trazodone hydrochloride in chronic low back pain syndrome. 214 65

Trazodone (150 mg to 400 mg) was administered to six depressed patients with significant sleep disturbances in an 8-week single-blind study design. Patients were evaluated psychologically by means of the Hamilton Rating Scales for Anxiety and Depression. Polysomnographic monitoring in the sleep laboratory was conducted at each of the time points corresponding to the psychiatric evaluations. Five of the six subjects completed treatment. Patients showed a significant improvement in symptoms of depression and in their polysomnographic-determined sleep architecture. There was a 44% improvement in persistent sleep latency, decreasing from a mean +/- SD of 51.0 +/- 59.3 minutes at baseline to 28.5 +/- 24.2 minutes after 5 weeks of active treatment. Total sleep time improved 14% from 387.1 +/- 59.2 minutes at baseline to 441.3 +/- 23.7 minutes after 5 weeks. Stage IV sleep more than doubled with an increase of 153% from 1.9 +/- 3.0% at baseline to a more normal 4.8 +/- 5.5%. There was no change in percentage of rapid eye movement (REM); however, REM latency increased 28% from a mean of 74.6 +/- 35.9 minutes at baseline to a mean of 95.6 +/- 28.8 minutes. Sleep efficiency improved from 80.6 +/- 12.3%, considered clinically significant insomnia, to 91.9 +/- 4.9%, which is well within normal sleep patterns.
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PMID:Sleep laboratory evaluation of the effects and efficacy of trazodone in depressed insomniac patients. 221 59

Efficacy being constant, antidepressant choice is dictated by side effect profile, patient acceptance, and safety. Trazodone has been shown to be safe in overdose, and the side effect profile is mild, with sedation the most common side effect. Sleep electroencephalogram and clinical studies have shown trazodone effective in improving sleep in normal subjects, insomniac patients, and patients with major depression. Tolerance and rapid eye movement rebound on discontinuation do not occur. The 3- to 9-hour half-life of trazodone and its pharmacokinetics favors a dose weighted at bedtime. Studies comparing multiple daytime dosing to single dosing at bedtime have shown equal efficacy in relieving depression. At treatment onset, a single nighttime dose is more productive of sleep with less daytime drowsiness. These differences between single nighttime dosing and multiple daily dosing disappear with continued administration. Geriatric patients respond similarly. Trazodone is best dosed at 150 mg given predominantly (but not necessarily all) at bedtime and increased as needed to 200 to 300 mg for full antidepressant efficacy.
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PMID:Trazodone dosing regimen: experience with single daily administration. 221 61

Priapism occurred in ten patients undergoing treatment of depression with trazodone or impotence with papaverine. Trazodone-related priapism uniformly required surgical procedures and resulted in impotence in two of three cases. In contrast, papaverine-associated priapism was successfully managed by aspiration and all seven patients continued to respond to intracorporal treatment. Iatrogenic priapism is an important complication of therapy with vasoactive drugs.
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PMID:Pharmacological priapism: comparison of trazodone- and papaverine-associated cases. 235 95

Trazodone was developed according to the mental pain hypothesis, which was postulated from studying patients and which proposes that depression is associated with a decreased pain threshold. Trazodone is devoid of the typical aminergic properties of tricyclics and monoamine oxidase inhibitors. Its preeminent effects are increased pain threshold and alpha-adrenergic blockade. The "dys-stress" hypothesis maintains the concept of the decreased pain threshold in depression, but attributes it to a pathology of the stress response. Whereas physiologically this response produces various effects, including analgesia and alertness that improve the mental and physical performance, in some individuals it is impaired. Abnormalities of the stress response are proposed to be a predisposing or pathogenetic factor for depression and other conditions. According to the "dys-stress" hypothesis, the alpha-adrenergic blockade produced by trazodone and its congeners would also be implicated in its antidepressant activity, as well as its side effects and preferential uses in depressive states associated with adrenergic hyperactivity.
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PMID:Trazodone: from the mental pain to the "dys-stress" hypothesis of depression. 256 77

In the United States, trazodone has shown efficacy comparable with tricyclic antidepressants. Trazodone's side-effect profile, however, is vastly superior to the older drugs. In cases of overdose, trazodone alone has not caused a single death. For depressed patients, starting with 150 mg/day of trazodone, preferably at night, produces best results. Preliminary data suggest good safety and efficacy for patients with chronic depression when used up to 5 1/2 years. New uses for trazodone include treatment of insomnia, chronic pain, obsessive-compulsive disorder (OCD), bulimia nervosa, and psychogeriatrics.
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PMID:United States experience and perspectives with trazodone. 266 50

Trazodone and tricyclics share similar activity towards the core symptoms of depression, whereas their effects on neurohumoral transmission tend to be opposite. This once again casts doubt upon the theories on depression postulated from the study of monoamine oxidase inhibitors and tricyclics. The effects of trazodone and tricyclics on the autonomic nervous system are also different, reflecting, respectively, the alpha-adrenergic blocking activity of the former and the muscarinic-anticholinergic and alpha-adrenergic stimulating properties of the latter. It is stressed that the autonomic changes that accompany depression to some extent overlap those produced by tricyclics, whereas they are generally relieved by trazodone. This drug, therefore, extends the previous limitations of antidepressant treatment.
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PMID:Beyond the limits of typical antidepressants. 283 63

Trazodone, a non-tricyclic molecule, represents the first of a new generation of antidepressants. It is currently marketed in a number of European countries, in the United States and in Latin America. The pharmacological and biochemical data, the mechanism of action and the preferential indications of trazodone are presented and compared to those of imipramine and other tricyclics. Unlike imipramine, trazodone inhibits the adrenergic system. The two molecules have anti-nociceptive properties, similar effects on the serotoninergic system and, after repeated administrations, they both reduce the density of beta-receptors. The clinical implications of the alpha-blocking activity of trazodone are reported. Trazodone is preferable to tricyclic anti-depressants in the treatment of depression in elderly subjects in general, and especially when they present closed angle glaucoma, prostatic hypertrophy, tremor or cardiovascular problems due to hyperactivity of the adrenergic system, as well as in organic depressions and in depression secondary to schizophrenia, alcoholism and in patients with Parkinson's disease.
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PMID:[History and pharmacology of trazodone]. 288 Jul 11

Fluoxetine and trazodone were compared in a double-blind, randomized, parallel, 6-week trial in 43 outpatients with major depression after a 1-week single-blind placebo period. Thirty-five patients completed at least 3 weeks of active medication, while 25 patients completed all 6 weeks. Response rates, whether defined by end-of-treatment Hamilton Rating Scale for Depression (HAM-D) score less than 10 or by a 50% reduction in HAM-D scores, were equivalent for the two medications. For fluoxetine, HAM-D scores were significantly lower at Weeks 1 and 2 compared with those of trazodone. Trazodone improved sleep significantly more than fluoxetine. Fluoxetine was associated more frequently with weight loss (p = .002) and less frequently with dizziness (p = .04) than trazodone.
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PMID:Fluoxetine versus trazodone in the treatment of outpatients with major depression. 305 68


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