Trazodone In Patients Research Articles

Study on the Efficacy of Shugan Jieyu Capsules Combined with Trazodone in Patients with PostStroke Depression and Insomnia

Objective: To analyze the effectiveness of applying ShuGan JieYu Capsules (SGJYC) combined with trazodone in patients with post-stroke depression (PSD) with insomnia. Methods: 60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group (trazodone) and a research group (SGJYC combined with trazodone) of 30 cases each. Statistics were analyzed using the Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Activities of Daily Living (ADL) scale before treatment and 4, 8, and 12 weeks after treatment. Results: Before treatment, The results of HAM-D, PSQI, and ADL scale studies in the two groups before treatment were not statistically significant (P > 0.05); 4, 8, and 12 weeks after treatment, the results of HAM-D and PSQI studies in the research group were lower than that of the reference group, and the results of ADL scale studies were higher than that of the reference group. There was a significant difference between the groups (P < 0.05). The total adverse reaction rate of the research group was lower than that of the reference group, and there was a significant difference between the groups (P < 0.05). Conclusion: The combination of SGJYC and trazodone reduced depression in post-stroke patients, corrected insomnia, improved sleep quality, was safe, and had a low rate of adverse reactions.

0343 Association between the real-world use of trazodone and daytime impairment in US patients with insomnia

Abstract Introduction Trazodone is approved for the treatment of depression and is used off-label to treat insomnia despite Clinical Practice Guidelines recommending against this use. The objective of this real-world retrospective study is to explore whether trazodone use is associated with improvements in daytime impairment in US patients with insomnia. Methods Information on insomnia patients aged ≥ 18 years prescribed trazodone as first-line treatment between October 2015 and March 2020 was retrieved from HealthVerity. Insurance claims data were extracted for each patient alongside physician notes in free-text form. From the claims, patient demographics and prescription information were extracted. An ontology analogous to the Insomnia Daytime Symptoms and Impact Questionnaire (IDSIQ) was designed with three domains (i.e., alert/cognition, mood and sleepiness). The 14 IDSIQ terms were extended to 109 terms to reflect physicians’ language. Daytime impairment symptom frequency occurring from 182 days before treatment to ~3 months (mean) during treatment was measured as annualized rates normalized by one year as the duration before and during treatment is different. Each symptom noted in a visit is counted once in a specific domain. Results were stratified by dose: trazodone < 150mg (typically used for off-label insomnia treatment) and trazodone ≥150mg (approved dose for depression treatment). Results 1187 and 246 unique patients were identified on the < 150mg and ≥150 mg trazadone doses, respectively. For trazodone < 150mg, the annualized rate of daytime impairment symptoms before and during treatment was 139.4 and 147.5, respectively, with a statistically non-significant overall increase (6%, p=0.313) and statistically non-significant increases in each domain (alert/cognition: 4%,p=0.574; mood: 10%, p=0.173; sleepiness: 5%,p=0.401). For ≥150mg trazodone, the annualized rate of daytime impairment symptoms before and during treatment was 143.5 and 142.2, respectively, with a statistically non-significant overall decrease (1%,p=0.941), statistically non-significant decreases in the alert/cognition (19%,p=0.128) and sleepiness (5%,p=0.712) domains and statistically non-significant increase in the mood domain (14%,p=0.400). Conclusion Patients with insomnia prescribed trazodone show similar levels of daytime impairment before and during treatment. This study suggests that the use of trazodone in patients with insomnia is not associated with a decrease in daytime impairment. Support (if any) Idorsia Pharmaceuticals Ltd.

Safety and efficacy of melatonin, clonazepam, and trazodone in patients with Parkinson's disease and sleep disorders: a randomized, double-blind trial.

Sleep disturbances are common non-motor symptoms of Parkinson's disease (PD). We aimed to compare the safety and efficacy of trazodone with melatonin and clonazepam in patients with PD and sleep complaints. This single-center, double-blind, randomized clinical trial was conducted on PD patients with subjective sleep complaints. Eligible patients were randomized 1:1:1 to receive melatonin 3mg/day, clonazepam 1mg/day, or trazodone 50mg/day for 4weeks. The primary outcome measure was the changes in Pittsburgh Sleep Quality Index (PSQI) scores. The mean change in Epworth Sleepiness Scale (ESS) and RBD screening questionnaire (RBDSQ) was considered as the secondary outcome measures. A total of 112 eligible patients were randomized and 93 participants, melatonin (n = 31), trazodone (n = 31), and clonazepam (n = 31), completed the study. There was a significant decrease in PSQI scores after 4weeks of treatment in all groups. The mean changes of PSQI from baseline were similar among the treatment arms (P = 0.325). Mean changes of RBDSQ and ESS from baseline were significantly different between study arms (P < 0.05). Melatonin intake was associated with a higher decrease in RBDSQ score compared to trazodone (P = 0.011) and clonazepam (P = 0.004). Trazodone intake was associated with a higher decrease in ESS score compared to clonazepam (P = 0.010). Mild adverse events were reported in three patients in the clonazepam, two patients in the trazodone group, and none in the melatonin group. Trazodone 50mg/day, clonazepam 1mg/day, and melatonin 3mg/day were all tolerable and effective in improving sleep quality in patients with PD. Iranian Registry of Clinical Trials (registration number; IRCT20170821035819N2).

P.315 Evaluating the efficacy of once a day trazodone in patients with major depressive disorder in two randomized, double blind studies

P.315 Evaluating the efficacy of once a day trazodone in patients with major depressive disorder in two randomized, double blind studies

Analysis of Trazodone and Pregabalin in Neurocognitive Disorders with Psychomotor Agitation

Background Patients diagnosed with neurocognitive disorders have behavioral disturbances, like aggression, self-harming behaviors, psychomotor agitation, impulsivity, that are difficult to manage in a population with comorbidities, pharmacodynamic and pharmacokinetic specific features. Objective To evaluate the comparative efficacy of pregabalin and trazodone in patients diagnosed with neurocognitive disorders that associate behavior disturbances. Method We selected a group of 30 patients, admitted in our department, diagnosed with neurocognitive disorders, who also presented severe behavioral symptoms of sufficient importance to necessitate specific treatment. Patients received either trazodone (100-200 mg flexible daily dose) or pregabalin (75-150 mg flexible daily dose) for 4 weeks. All participants in this trial were assessed weekly using Global Assessment of Functioning (GAF), Mini Mental State Examination (MMSE), Instrumental Activities of daily Living Scale (IADL) and Neuropsychiatric Inventory (NPI). Results Patients receiving pregabalin had a better efficacy/tolerability rapport, reflected in the lowest rate of discontinuation due to side events (p Conclusion Patients with behavior disturbances associated to neurocognitive disorders may benefit from pregabalin or trazodone treatment, although there are marked differences regarding individual responses and the overall impact on the NPI are relatively small.

An Observational Study of Insomnia and Nightmare Treated With Trazodone in Patients With Advanced Cancer

Patients with cancer often experience insomnia. Nightmares are also a strong factor that interferes with the maintenance of comfortable and satisfying sleep. However, the prevalence and standard treatment of nightmares in patients with cancer have not been established yet. We aimed to treat insomnia and nightmares with trazodone. From 2008 to 2011, trazodone was prescribed to 30 patients with cancer who reported experiencing insomnia with or without nightmares to the palliative care team in Osaka University Hospital. Effective treatment was seen in 15 patients (50%). Four patients with cancer reported having severe nightmares and 2 patients had beneficial effects, with frightening dreams transformed into acceptable ones. Trazodone may be an effective drug for the treatment of insomnia and nightmares in patients with advanced cancer.

Trazodone and Alcohol Relapse: A Retrospective Study Following Residential Treatment

Trazodone is one of the most commonly prescribed hypnotic medications in patients with sleep disturbances in alcohol recovery. A recent study concluded that treating insomnia with trazodone in patients with alcohol dependence might impede improvements in alcohol consumption and lead to increased drinking when trazodone is stopped. We set out to investigate the relationship between trazodone use during alcoholism treatment and relapse rates in patients who were discharged from a residential alcohol treatment program. We retrospectively reviewed records of patients with a diagnosis of alcohol dependence in a residential addiction treatment center from 2005 to 2008 and analyzed the association of trazodone use at discharge and alcohol relapse at 6 months. We also assessed the association between trazodone use and relapse at 6 months adjusting for sex, drug dependence, nonsubstance use Axis I psychiatric diagnoses, patient self-report of difficulties with sleep, and anti-dipsotropic medication use at discharge and evaluated pair-wise interactions of trazodone use with the adjustment variables. Of 283 patients eligible for inclusion, 85 (30%) were taking trazodone at discharge. Older age, self-reported sleep problems, and having a nonsubstance use Axis I psychiatric diagnosis were associated with trazodone use. After discharge, 170 (60%) subjects responded to follow-up efforts. Neither intent to treat nor responder only analysis revealed any association between trazodone use and relapse. Our retrospective study of a complex patient population discharged from a residential treatment setting did not find an association between trazodone use at discharge and relapse rates at 6 months.

Herb-Drug Interactions

Herbs are often administered in combination with therapeutic drugs, raising the potential of herb-drug interactions. An extensive review of the literature identified reported herb-drug interactions with clinical significance, many of which are from case reports and limited clinical observations. Cases have been published reporting enhanced anticoagulation and bleeding when patients on long-term warfarin therapy also took Salvia miltiorrhiza (danshen). Allium sativum (garlic) decreased the area under the plasma concentration-time curve (AUC) and maximum plasma concentration of saquinavir, but not ritonavir and paracetamol (acetaminophen), in volunteers. A. sativum increased the clotting time and international normalised ratio of warfarin and caused hypoglycaemia when taken with chlorpropamide. Ginkgo biloba (ginkgo) caused bleeding when combined with warfarin or aspirin (acetylsalicylic acid), raised blood pressure when combined with a thiazide diuretic and even caused coma when combined with trazodone in patients. Panax ginseng (ginseng) reduced the blood concentrations of alcohol (ethanol) and warfarin, and induced mania when used concomitantly with phenelzine, but ginseng increased the efficacy of influenza vaccination. Scutellaria baicalensis (huangqin) ameliorated irinotecan-induced gastrointestinal toxicity in cancer patients.Piper methysticum (kava) increased the 'off' periods in patients with parkinsonism taking levodopa and induced a semicomatose state when given concomitantly with alprazolam. Kava enhanced the hypnotic effect of alcohol in mice, but this was not observed in humans. Silybum marianum (milk thistle) decreased the trough concentrations of indinavir in humans. Piperine from black (Piper nigrum Linn) and long (P. longum Linn) peppers increased the AUC of phenytoin, propranolol and theophylline in healthy volunteers and plasma concentrations of rifamipicin (rifampin) in patients with pulmonary tuberculosis. Eleutheroccus senticosus (Siberian ginseng) increased the serum concentration of digoxin, but did not alter the pharmacokinetics of dextromethorphan and alprazolam in humans. Hypericum perforatum (hypericum; St John's wort) decreased the blood concentrations of ciclosporin (cyclosporin), midazolam, tacrolimus, amitriptyline, digoxin, indinavir, warfarin, phenprocoumon and theophylline, but did not alter the pharmacokinetics of carbamazepine, pravastatin, mycophenolate mofetil and dextromethorphan. Cases have been reported where decreased ciclosporin concentrations led to organ rejection. Hypericum also caused breakthrough bleeding and unplanned pregnancies when used concomitantly with oral contraceptives. It also caused serotonin syndrome when used in combination with selective serotonin reuptake inhibitors (e.g. sertraline and paroxetine). In conclusion, interactions between herbal medicines and prescribed drugs can occur and may lead to serious clinical consequences. There are other theoretical interactions indicated by preclinical data. Both pharmacokinetic and/or pharmacodynamic mechanisms have been considered to play a role in these interactions, although the underlying mechanisms for the altered drug effects and/or concentrations by concomitant herbal medicines are yet to be determined. The clinical importance of herb-drug interactions depends on many factors associated with the particular herb, drug and patient. Herbs should be appropriately labeled to alert consumers to potential interactions when concomitantly used with drugs, and to recommend a consultation with their general practitioners and other medical carers.

A Comparison of Venlafaxine, Trazodone, and Placebo in Major Depression

A double-blind, placebo-controlled trial was undertaken to compare the safety and efficacy of venlafaxine and trazodone in patients with major depression. Two hundred twenty-five patients entered an initial 6-week treatment phase, and 149 completed it. Ninety-six patients who were responders continued in a 1-year, double-blind, long-term phase during which they received the same medication and doses they had during the short-term phase. Both active treatments were significantly more effective than placebo on some measures during the short-term study, but venlafaxine produced more improvement in the cognitive disturbance and retardation factors on the Hamilton Rating Scale for Depression. Trazodone was more effective against the sleep disturbance factor. Patients on venlafaxine were most likely to enter the long-term phase and to remain in the trial longest. The side effect profiles of the three treatment groups were compared. Venlafaxine was most likely to cause nausea, whereas trazodone was associated with the most dizziness and somnolence.