(Legend)

Generic Name

• Trazodone
  T½ = 5–9 h
  Protein binding = 89%–95%
  Pregnancy category C [Desyrel discontinued]

Trade Name

• Oleptro
• Trazorel

Dose Range/Adult Daily Dose

• Range: 150–400 mg/d (hospitalized up to 600 mg/d)
  Depression: 50 mg po tid (150 mg/d), up to 400 mg/d (titrate 50 mg every 4 d).
  Insomnia: 25–100 mg hs
  Oleptro: Start 150 mg once daily; max dose 375 mg/d

Use/Common Side Effects (CSE)

• Use: Major depression.
  Off label: Insomnia
  CSE: Drowsiness, hypotension, dry mouth, PRIAPISM; may also experience confusion, dizziness, insomnia, nightmares, palpitations, impotence, myalgia

Geriatric & Dose Considerations

• Reduce dose initially.
  Start: 75 mg/d po in divided doses, increase every 4 d; titrate slowly; caution w CV, hepatic, renal disease.
  Observe elderly for drowsiness & hypotension; caution about slow positional changes

Classification

• Antidepressant/sedative

Assessment Cautions

• PRIAPISM (prolonged erection): Medical emergency; avoid alcohol, concomitant use with fluoxetine, opioids, and drugs that inhibit and induce the CYP3A4 enzyme system; also kava, valerian (↑ CNS depression), St. John’s wort and SAMe