Trazodone
Mechanism :
It is an atypical antidepressant used in the treatment of obsessive-compulsive disorders, antidepressants and phobias. It is used in children more than 6 years of age.
Indication :
Contraindications :
Do not use trazodone if you have taken a MAO inhibitor in the past 14 days; Hypersensitivity; Some young people have thoughts about suicide when first taking an antidepressant.
Dosing :
6 to 12 years:
Initial dose: 1.5 to 2 mg/kg/day PO in divided doses. May increase up to 6 mg/kg/day in 3 divided doses.
>12 years to 18 years:
Initial dose: 25 to 50 mg per day. May increase up to 100 to 150 mg per day in divided doses.
Trazodone should be taken shortly after a meal or light snack.
Adverse Effect :
Headache, confusion, dizziness, dry mouth, nausea, vomiting, fatigue, constipation, blurred vision.
Interaction :
Amitriptyline: Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Buspirone: Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Carbamazepine: The CYP3A4 inducer, Carbamazepine, may decrease Trazodone efficacy by increasing Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Carbamazepine is initiated, discontinued or dose changed.
Cimetidine: The CYP3A4 inhibitor, Cimetidine, may increase Trazodone efficacy/toxicity by decreasing Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Cimetidine is initiated, discontinued or dose changed.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function. Start with small doses and increase gradually |
| <10 | Start with small doses and increase gradually DOSE IN PATIENTS |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Dose adjustment guidelines are not available. Use cautiously. Dose reduction may be needed as the drug has extensive hepatic metabolism.