USMLE

Trazodone

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Mental Health Drugs
  1. Tricyclic Antidepressants
  2. SSRIs
  3. SNRIs
  4. Benzodiazepines
  5. Barbiturates
  6. Typical Antipsychotics
  7. Atypical Antipsychotics
  8. Lithium
  9. MAOIs
  10. Bupropion
  11. Buspirone
  12. Trazodone
  13. Zolpidem
  14. Amphetamines

Summary

Trazodone is an atypical antidepressant drug used to treat depression. Side effects of the drug include orthostatic hypotension, sedation, and priapism.

Key Points

  • Mechanism
    • Atypical antidepressant
      • Increases serotonin levels in the brain
      • Blocks alpha and H1 receptors
    • Clinical Use
      • Depression
        • Atypical antidepressant thought to work by modulating serotonin and catecholamine signaling
        • Often used in combination therapy with another antidepressant
      • Insomnia
        • Used off label due to sedative side effect
        • Due to blockade of H1 receptors in the brain
    • Side Effects and Adverse Reactions
      • Priapism
        • Prolonged painful erection (>2 hours) that can lead to tissue hypoxia and necrosis if not treated immediately
        • Medical emergency
      • Drowsiness/Sedation
        • Take at night to avoid daytime sleepiness
        • Should not be taken with other CNS depressants (benzodiazepines, alcohol, antihistamines, etc.)
      • Orthostatic Hypotension
        • Advise patient to rise slowly to avoid sudden drop in blood pressure
        • Older patients are at higher risk for falls