Trazodone SSRIs

Agitation (chronic) Sodium divalproex Risperidone Olanzapine SSRI Trazodone Ziprasidone Haloperidol... 

Adverse interactions of lithium with tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors have been reviewed (581). In reviews of antidepressants and the serotonin syndrome, a possible contributory role has been suggested for lithium, based on case reports with tricyclic antidepressants, SSRIs, trazodone, and venlafax-ine (204,582). 

TCAs DULOXETINE, SSRIs, TRAZODONE t risk of serotonin syndrome >- For signs and symptoms of serotonin toxicity, see Clinical Features of Some Adverse Drug Interactions, Serotonin toxicity and serotonin syndrome Additive effect TCAs block uptake reuptake of serotonin. In addition, TCAs inhibit CYP2D6-mediated metabolism of SSRIs Caution with co-administration. Specialist advice should be sought and alternatives considered... 

Venlafaxine extended release, duloxetine, paroxetine, and escitalopram are FDA approved for treatment of GAD. Sertraline is also effective. Acute response and remission rates are approximately 65% and 30%, respectively. Imipramine may be used when patients fail to respond to selective serotonin reuptake inhibitors (SSRIs). In one trial, diazepam, trazodone, and imipramine had greater anxiolytic activity than placebo. 

Many commonly used medications also contain substances that are eliminated by the MAOIs and must not be taken by these patients. The list of medications to be avoided inclndes the narcotic pain reliever meperidine (Demerol), and many over-the-connter cold remedies containing dextromethorphan or pseudoephedrine. Finally, patients taking MAOIs must also avoid medications that elevate serotonin levels. This inclndes certain appetite snppressants and antidepressants including the SSRIs, venlafaxine, duloxetine, mirtazapine, nefazodone, and trazodone. Medications that interact with the MAOIs cannot be taken until at least 2 weeks after the MAOI has been stopped. 

Atypical Antidepressants. The atypical antidepressants are not a true class in the same sense as SSRIs or TCAs. There is no unifying property to these antidepressants. Each of these antidepressants is actually a class unto itself that is structurally and functionally different from all other antidepressants. The atypical antidepressants include trazodone (Desyrel), bupropion (Wellbutrin), venlafaxine (Effexor), duloxetine (Cymbalta), nefazodone (Serzone), and mirtazapine (Remeron). 

Trazodone (Desyrel). Trazodone was the first of the atypical antidepressants and was actually introduced prior to the SSRIs. It does not have the serious cardiac toxicity or anticholinergic side effects of the TCAs and was the most popular antidepressant until the arrival of the SSRIs. It is approved for the treatment of depression and is also commonly used in low doses to treat agitation in demented patients and insomnia. 

Dementia SSRIs Bupropion Duloxetine Mirtazapine Nefazodone Trazodone Venlafaxine TCAs... 

Agitation (acute, mild) Trazodone Lorazepam Buspirone Sodium divalproex SSRI ... 

Brief Mild Agitation. For the acnte treatment of mild agitation without physical aggression, low doses of trazodone are preferred. If this mild agitation persists, several options are available. Yonr patient s physician may continne to nse trazodone or may prefer sodinm divalproex (Depakote), bnspirone (Buspar), or any of the SSRI antidepressants. These are all well tolerated bnt should be started at low doses and slowly raised npward as needed. 

Chronic Agitation. For chronic agitation with physical aggression, sodium divalproex is the preferred treatment. If divalproex is ineffective, haloperidol or an atypical antipsychotic can be added or snbstituted. Other options include trazodone, carbamazepine, and SSRI antidepressants. 

Examples trazodone, nefazodone 5-HTiA arid 5-HT2 antagonists, weak SSRI activity alpha-1 and HI antagonism... 

Trazodone (Apothecon) is also classified as an antidepressant agent. It is a selective serotonin reuptake inhibitor (SSRI), partial agonist at postsynaptic 5-HTia receptors, and exhibits a-adrenoceptor blocking actions. 

Therapy with phentolamine may result in reflex tachycardia, arrhythmias, and hypotension the latter effect can be exacerbated by other vasodilatory drugs and by the simultaneous ingestion of ethanol. The pharmacological actions of trazodone can be reduced by paroxetine and possibly other SSRIs. 

Fenfluramine Dextromethorphan Meperidine Methylene dioxymethamphetamine Meta-chlorophenylpiperazine (mCPP) Trazodone (mCPP) Selegiline Nefazodone Trazodone Pethidine Tramadol Mirtazapine TCA medications Venlafaxine SSRI agents... 

Trazodone has relatively few drug interactions. Medications that induce or inhibit first-pass metabolism may affect trazodone s plasma concentration. Even though trazodone is commonly used for SSRI-induced insomnia, it may be counter productive. Compounds such as... 

Trazodone has been used therapeutically, but because of low potency and marked sedative effects, its use has been mostly restricted to a sleeping aid in doses of 50-100 mg at bedtime. It has been routinely used in adults on SSRIs, who develop sleep problems. The concern about priapism even at low doses may reduce enthusiasm for its use in male children and adolescents. 

Agents such as nefazodone, trazodone, and cyproheptadine, used alone or in conjunction with the SSRIs, may be particularly useful in sleep dysregulation and trauma-related nightmares that frequently occur in pediatric PTSD patients. 

Venlafaxine, paroxetine, sertraline, imipramine, and trazodone have all proven effective in relieving symptoms of GAD. Venlafaxine, a combined serotonin and norepinephrine reuptake blocker, may be an exceptionally good choice for people who have other psychiatric illnesses in addition to GAD, or when it is not clear whether the patient has GAD or a depressive illness, or both. Although, to date, only certain SSRIs have been... 

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