Trazodone drug overdose

Drug Trazodone (Desyrel) Mechanism (Amineselectivity) Slight inhibition of serotonin re uptake Advantages Sedating useful in agitation lower relative risk of overdose Disadvantages May cause orthostatic hypotension (similar to nefazodone) serious problems related to priapism may also occur in men... 

Trazodone Hydrochloride Trazodone overdose causes severe toxic effects. These effects are severe if taken along with benzodiazepines or alcohol. Trazodone interacts with MAOIs, cardiovascular drugs, CNS depressants, and antiepileptics. 

In a 1980 review there were 68 cases of trazodone overdosage in amounts ranging up to 5 g (12 times the maximum therapeutic dose) (32). The predominant symptoms were drowsiness, dizziness, and rarely coma. There were no deaths in patients who took trazodone alone, and only two in those who took it in combination with other potentially lethal drugs. A brief review of data obtained from 46 cases of trazodone overdose reported to the National Poisons Information Service in London showed that 25 of the patients took overdoses of trazodone alone, while 21 took trazodone in combination with other drugs (33). This retrospective questionnaire study had inherent methodological flaws, but it did lend credence to the belief that trazodone is safe in overdose. 

Trazodone has structural similarities with TCAs but probably acts by antagonism of postsynaptic serotonin receptors and presynaptic a-adrenoceptors. It is an option for depressed patients where heavy sedation is required. Trazodone also has the advantages of lacking antimuscarinic effects and being relatively safe in overdose. Males should be warned of the possibility of priapism (painful penile erections), attributable to the drug s blockade of ttj-adrenoceptors. 

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