Insomnia trazodone

Adverse reactions with administration of bupropion include citation, dry mouth, insomnia, headache, nausea, constipation, anorexia, weight loss, and seizures. Fluoxetine administration may result in headache, activation of mania or hypomania, insomnia, anxiety, nervousness, nausea, vomiting, and sexual dysfunction. Trazodone administration may cause the following adverse reactions drowsiness, skin disorders, anger, hostility, anemia, priapism, nausea, and vomiting. Additional... 

The increasing popularity of sedating antidepressants for the treatment of insomnia resulted in trazodone being the most prescribed drug in 2002.39 Other common antidepressants also... 

Trazodone, 25 to 100 mg, is often used for insomnia induced by selective serotonin reuptake inhibitors or bupropion. Side effects include serotonin syndrome (when used with other serotonergic drugs), oversedation, a-adrenergic blockade, dizziness, and rarely priapism. 

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. 

Antidepressants. For three apparent reasons, antidepressants have long been used to treat insomnia. First, some of them are quite sedating. In particular, doxepin (Sinequan), amitriptyline (Elavil), and trazodone (Desyrel) have been used to treat... 

Nevertheless, sedative-hypnotic agents often play a useful role in treatment. In particular, by providing a successful night s sleep, these medications can break the cycle of anxious anticipation and dread that afflicts the insomnia sufferer during the night. We generally prefer using zolpidem or zaleplon as a first-line treatment for early-to-middle insomnia. Late insomnia often responds well to trazodone or eszopiclone, and trazodone often is a first choice in the presence of substance abuse for all insomnias. 

Insomnia Trazodone Quetiapine Zolpidem Temazepam Chloral hydrate ... 

The antidepressant trazodone (Desyrel) is commonly used in low doses to treat agitation or insomnia in dementia patients. However, older patients often do not tolerate the higher doses of trazodone needed to treat depression. 

We recommend trazodone (Desyrel) as a hrst-line treatment for insomnia in dementia patients. It has the added advantage of reducing nighttime agitation due to sundowning. Trazodone should be started at 25-50 mg given at bedtime. It should not be increased above 100 mg as higher doses increase the risk of dizziness and falls. 

Trazodone Blocks histamine receptor KSerotonin Depression Insomnia... 

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... 

Other new antidepressants, including bupropion, ven-lafaxine, nefazodone, and mirtazapine, have been found to be efficacious in the treatment of depressed adults, but only a few open-label studies have been carried out in children and adolescents (e.g., Daviss et ah, 2001). Bupropion and velanfaxine may be useful in treating youth with MDD and ADHD (Plizka, 2000 Daviss et ah, 2001). Because of the sedative effects of mirtazapine and trazodone, these medications have been used as adjunctive treatments for patients with severe insomnia. 

Nierenberg AA, Amsterdam JD Resistant depression definition and treatment approaches. J Chn Psychiatry 51 (suppl) 39-47, 1990 Nierenberg AA, Adler LA, Peselow E, et al Trazodone for antidepressant-associated insomnia. Am J Psychiatry 151 1069-1072, 1994a Nierenberg AA, Feighner JP, Rudolph R, et al Venlafaxine for treatment-resistant unipolar depression. J Chn Psychopharmacol 14 419-423, 1994b... 

Trazodone is an older antidepressant that is associated with significant sedation. Currently, trazodone is not recommended as a first-line antidepressant because of an increased risk of orthostatic hypotension, arrhythmias, and priapism. Also, compared with other available antidepressants, trazodone does not offer an advantage in terms of therapeutic efficacy. However, trazodone may be useful in patients with insomnia. It is currently common practice to use low doses of trazodone (e.g., 50-100 mg) to assist with initial insomnia while starting treatment with one of the newer antidepressants to address the underlying depression. If this strategy is used, we recommend tapering the trazodone dose and discontinuing treatment with trazodone after 4—6 weeks. 

Although benzodiazepines, zolpidem, zaleplon, and eszopiclone are the mainstay of pharmacotherapy for insomnia, other sedating drugs, such as trazodone, diphenhydramine, or chloral hydrate, also may be used. Insomnia should first be addressed diagnostically, and in most cases, nonpharmacological interventions should be attempted before treatment with a hypnotic is instituted. Hypnotic agents should be administered in the lowest effective dose. Medications commonly prescribed for insomnia, along with their recom-... 

If patients have predominant symptoms of insomnia or psychomotor agitation, a more sedating drug (e.g., trazodone or mirtazapine) may benefit initially but could be problematic later in therapy (i.e., cause excessive sedation once sleep normalizes). 

To manage withdrawal insomnia, we recommend the supplemental use of hypnotics such as zolpidem or a sedating antidepressant such as trazodone. Rickels et al. recommend the supplemental use of hypnotics such as diphenhydramine, doxylamine, or chloral hydrate or a sedating TCA such as doxepin ( 259). These investigators also recommend that chronic BZD users with evidence of depression or panic be treated with adequate doses of an appropriate antidepressant, a management technique that may help patients succeed in discontinuation. 

Sedative effects, particularly with trazodone, can be quite pronounced. Thus, it is not surprising that the treatment of insomnia is currently the primary application of trazodone. The gastrointestinal effects appear to be dose-related and are less pronounced than those seen with SNRIs or SSRIs. Sexual effects are uncommon with nefazodone or trazodone treatment as a result of the relatively selective serotonergic effects of these drugs on the 5-HT2 receptor rather than on... 

Mendelson WB A review of the evidence for the efficacy and safety of trazodone in insomnia. J Clin Psychiatry 2005 66(4) 469. [PMID 15816789]... 

Perhaps the most commonly used example of the serotonin 2A strategy is the combination of an SSRI with trazodone. Clinicians have long recognized that trazodone will improve the agitation and insomnia often associated with SSRIs, allow high doses of the SSRI to be given, and consequently boost the efficacy of the SSRI not only in depression, but also in obsessive-compulsive disorder and other anxiety disorders. Thus, both types of bad math are in play here. 

The nonbenzodiazepine sedative-hypnotics zaleplon, zolpidem, and zopiclone are replacing benzodiazepine sedative-hypnotics as first-line treatments for insomnia. Some antidepressants, such as sedating tricyclic antidepressants and trazodone, are also used as sedative-hypnotic agents for the treatment of insomnia. 

Antidepressants. Although not specifically indicated to treat insomnia, antidepressant compounds are often used for their sedating properties, particularly when coexisting depression or anxiety are present. Newer antidepressants that often help with insomnia include trazodone (Desyrel) nefazodone (Serzone) mir-tazapine (Remeron) amytriptyline (Elavil) trim-ipramine (Surmontil) and doxepin (Sinequan). 

Trazodone, nefazadone Drowsiness, dizziness, insomnia, nausea, agitation... 

Trimipramine is a sedating tricyclic antidepressant that has been used as a hypnotic (1) it shares this activity with other drugs of its class, notably amitriptyline, dosulepin, doxepin, and trazodone, and with the tetracyclics mianserin and mirtazapine. Trimipramine may be preferred for this purpose, since it has less effect on sleep architecture, including REM sleep (2), and has only a modest propensity to produce rebound insomnia in a subset of patients (3). Sedative antidepressants may be particularly appropriate for individuals at risk of benzodiazepine abuse and patients with chronic pain (4). The usual pattern of tricyclic adverse effects, especially antimuscarinic and hypotensive effects and weight gain, can be expected. Some authors, enthusiastic about GABA enhancers, contend that antidepressants are not useful hypnotic alternatives (5). 

A 14-year-old boy with major depressive disorder responded to paroxetine 20 mg/day with full remission of depressive symptoms except insomnia (16). Diphenhydramine and trazodone did not improve his sleep and caused excessive daytime drowsiness. He then responded well to zaleplon 10 mg, but when he took two extra tablets 3 weeks later he developed complex behavior and sleepwalking. He had slurred speech, was slow in responding to questions, was moderately confused, and was uncoordinated and moved slowly. Physical examination, routine laboratory investigations, and an electrocardiogram were all normal. He remained in hospital for 8 hours and awakened without any memory of his activities. His mental state at 1 week and 1 month were both normal. 

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