![]() ![]() Trazodone reduces levels of neurotransmitters associated with arousal effects, such as serotonin, noradrenaline, dopamine, acetylcholine, and histamine. The unique property of trazodone, where it simultaneously inhibits SERT, 5-HT2A, and 5-HT2C receptors, avoids the issue of sexual dysfunction, insomnia, and anxiety that commonly presents with SSRIs and SNRIs therapy. Also, trazodone has better tolerance than second-generation SSRIs, which are highly associated with insomnia, anxiety, and sexual dysfunction. Ĭlinical studies have shown trazodone to be comparable in efficacy to other drug classes, such as TCAs (tricyclic antidepressants), SSRIs (selective serotonin reuptake inhibitors), and SNRIs (serotonin-norepinephrine receptor inhibitor) in treating major depressive disorders. Trazodone is in the category of SARI drugs (serotonin antagonist and reuptake inhibitors), with other members being phenylpiperazine, etoperidone, lorpiprazole, and mepiprazole. The full spectrum of trazodone’s mechanism of action is not fully understood, explaining its off-label uses. It also induces significant changes in 5-HT presynaptic receptor adrenoreceptors. Trazodone inhibits the reuptake of serotonin and blocks the histamine and alpha-1-adrenergic receptors. Trazodone is an antidepressant that works by inhibiting both serotonin transporter and serotonin type 2 receptors. It raises the respiratory threshold, lowering the risk of respiratory instability. Additionally, research has shown trazodone to improve apnea and hypopnea episodes in patients with obstructive sleep apnea (OSA), and the drug does not worsen hypoxemic episodes. ![]() However, various studies show patients with panic symptoms have suffered exacerbation in some instances, which is why SSRIs, instead of trazodone, are preferred as the first-line treatment for PTSD. The dose of 50 mg to 200 mg of trazodone has been demonstrated to reduce episodes of nightmares as well as improve sleep habits in studies involving PTSD patients. Trazodone has also been used for post-traumatic stress disorder (PTSD) if the first-line treatment use of SSRIs does not show efficacy. Trazodone is also used off-label for anxiety, Alzheimer disease, substance abuse, bulimia, and fibromyalgia due to its serotonergic receptor antagonism and serotonin reuptake inhibiting effects. Because of a lack of sufficient clinical data for justifying its use as a sleep aid, trazodone is not FDA-approved for sleep disorders. These patients may or may not have concurrent depression. Trazodone is used to induce sedation in patients with sleep problems. It can be used as part of combination therapy with other drugs or psychotherapies or used by itself for treating depression. Trazodone is an FDA-approved antidepressant for treating major depressive disorders. ![]()
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