TRAZODONE hydrochloride

Indications & Dose:

 Depressive illness (particularly where sedation is required)

•  BY MOUTH

Adult: Initially 150 mg daily in divided doses, dose to be taken after food, alternatively initially 150 mg once daily, dose to be taken at bedtime, increased if necessary to 300 mg daily; increased if necessary to 600 mg daily in divided doses, higher dose for use in hospital patients only

Elderly: Initially 100 mg daily in divided doses, dose to be taken after food, alternatively initially 100 mg once daily, dose to be taken at bedtime, increased if necessary to 300 mg daily; increased if necessary to 600 mg daily in divided doses, higher dose for use in hospital patients only

Anxiety

• BY MOUTH

Adult: 75 mg daily, increased if necessary to 300 mg daily

Elderly: Initially 1oomg in divided doses after meals or as single dose at night time, max; 300mg daily.

Child 6-18 yr: PO 1.5-2 mg/kg/day in divided doses initially, increase gradually q3-4d as needed; max 6 mg/kg/day divided tid

Children below 6 years not recommended. 

Contraindications:

 Acute porphyrias p. 930 . arrhythmias . during the manic phase of bipolar disorder . heart block . immediate recovery period after myocardial infarction 

Side Effects:

Cautions:

Precautions:

 Pre-existing cardiac disease, initial recovery phase of MI, children < 18 yr, suicidal ideation, electroconvulsive therapy

Interaction:

Drugs

Clonidine: Inhibited antihypertensive response to clonidine

Ethanol: Additive impairment of motor skills; abstinent alcoholics may eliminate cyclic antidepressants more rapidly than non-alcoholics

Fluoxetine: Increased plasma trazodone concentrations

MAOIs: Potential for fatal serotonin syndrome Neuroleptics: Additive hypotension 

Warnings:

Adverse Effects:

Lactations:

Excreted into human breast milk; effects on nursing infant unknown, but of possible concern 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Agitation, akathisia, anger, confusion, decreased concentration, delusions, disorientation, dizziness, drowsiness, excitement, extrapyramidal symptoms, fatigue, hallucinations, headache, hostility, hypomania, impaired memory, impaired speech, incoordination, insomnia, lightheadedness, mania, nervousness, nightmares or vivid dreams, numbness, paresthesia, psychosis, seizures, stupor, tardive dyskinesia, tremors, weakness

CV: Atrial fibrillation, bradycardia, cardiac arrest, chest pain, conduction block, dysrhythmias, edema, hypertension, hypotension; Ml, orthostatic hypotension, palpitations, syncope, tachycardia, vasodilation. ventricular ectopie activity

EENT: Blurred vision, diplopia, nasal and sinus congestion, red eyes, tinnitus, vertigo

GI: Abdominal or gastric disorder, bad taste in mouth, constipation, diarrhea, dry mouth; flatulence, hyperbilirubinemia, hypersalivation, inappropriate antid.iuretic hormone syndrome, intrahepatic cholestasis, jaundice, liver enzyme alterations, nausea, vomiting

GU: Breast enlargement and engorgement, decrease or increased libido, delayed; urine flow, early menses, hematuria, increased urinary frequency, impotence, lactation, missed periods, priapism, retrograde ejaculation, urinary incontinence or retention

MS: Aches and pains, ataxia, muscle twitches

RESP: Apnea, shortness of breath

SKIN: Alopecia, clamminess, pruritis, rash, sweating, urticaria

MISC: Decreased appetite, malaise, weight gain or loss

Patient And Carer Advice: