Antidepressant Medications Anti-depressant Drugs Antidepressant: trazodone, Desyrel

Antidepressant: trazodone, Desyrel

Generic Name: trazodone
Brand Name(s): Desyrel
Common Use: Antidepressant
Hypnotic

Trazodone is a psychoactive compound with sedative and anti-depressant properties.

For the symptomatic relief of depressive illness.

Contraindications

Known hypersensitivity to trazodone.

Trazodone may enhance the response to alcohol and the effects of barbiturates and other CNS depressants and patients should be cautioned accordingly. Increased serum digoxin and phenytoin levels have been reported to occur in patients receiving trazodone concurrently with either of those 2 drugs. Little is known about the interaction between trazodone and general anesthetics; therefore, prior to elective surgery, trazodone should be discontinued for as long as clinically feasible.

Because it is not known whether an interaction will occur between trazodone and MAO inhibitors, administration of trazodone should be initiated very cautiously with gradual increase in dosage as required, if an MAO inhibitor is given concomitantly or has been discontinued shortly before medication with trazodone is instituted.

Adverse Side Effects

The most common adverse reactions encountered are drowsiness, nausea/vomiting, headache and dry mouth.

Adverse reactions reported include the following:
Behavioral:
Drowsiness, fatigue, lethargy, retardation, lightheadedness, dizziness, difficulty in concentration, confusion, impaired memory, disorientation, excitement, agitation, anxiety, tension, nervousness, restlessness, insomnia, nightmares, anger, hostility and, rarely, hypomania, visual distortions, hallucinations, delusions and paranoia.
Neurologic:
Tremor, headache, ataxia, akathisia, muscle stiffness, slurred speech, retarded speech, vertigo, tinnitus, tingling of extremities, paresthesia, weakness, grand mal seizures, and, rarely impaired speech, muscle twitching, numbness, dystonia and involuntary movements.
Autonomic:
Dry mouth, blurred vision, diplopia, miosis, nasal congestion, constipation, sweating, urinary retention, increased urinary frequency and incontinence.
Cardiovascular:
Orthostatic hypotension, hypertension, tachycardia, palpitations, shortness of breath, apnea, syncope, arrhythmias, prolonged P-R interval, atrial fibrillation, bradycardia, ventricular ectopic activity (including ventricular tachycardia), myocardial infarction and cardiac arrest.
Gastrointestinal:
Nausea, vomiting, diarrhea, gastrointestinal discomfort, anorexia, increased appetite.
Endocrine:
Priapism, decrease and, more rarely, increase in libido, weight gain and loss, and rarely, menstrual irregularities, retrograde ejaculation and inhibition of ejaculation.
Allergic or toxic:
Skin rash, itching, edema, and, rarely, hemolytic anemia, methemoglobinemia, liver enzyme alterations, obstructive jaundice, leukocytoblastic vasculitis, purpuric maculopapular eruptions, photosensitivity and fever.
Miscellaneous:
Aching joints and muscles, peculiar taste, hypersalivation, chest pain, hematuria, red, tired and itchy eyes.

Overdose

Overdosage of trazodone may cause an increase in incidence or severity of any of the reported adverse reactions, e.g. hypotension and excessive sedation. There is no specific antidote for trazodone. Management of overdosage should, therefore, be symptomatic and supportive. Any patient suspected of having taken an overdosage should be admitted to hospital as soon as possible and the stomach emptied by gastric lavage.

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