Classifications: psychotherapeutic agent; antidepressant; Therapeutic: antidepressant
Pregnancy Category: C
50 mg, 100 mg, 150 mg, 300 mg tablets
Centrally acting antidepressant chemically and structurally unrelated to tricyclic, tetracyclic, or other antidepressants.
Potentiates serotonin effects by selectively blocking its reuptake at presynaptic membranes in CNS. Produces varying degrees
of sedation in normal and mentally depressed patient.
Increases total sleep time, decreases number and duration of awakenings in depressed patient, and decreases REM sleep. Has
antianxiety effect in severely depressed patient.
Both inpatient and outpatient with major depression with or without prominent anxiety.
Adjunctive treatment of alcohol dependence, anxiety neuroses, drug-induced dyskinesias, insomnia.
Initial recovery phase of MI; ventricular ectopy; electroshock therapy; suicidal ideation; pregnancy (category C). Safe
use in children <6 y is not established.
Bipolar disorder, older adults; history of suicidal tendencies; cardiac arrhythmias or disease; hepatic disease, renal impairment;
Route & Dosage
Adult: PO 150 mg/d in divided doses, may increase by 50 mg/d q34d (max: 400600 mg/d)
Geriatric: PO 2550 mg h.s., may increase q37d to usual range of 75150 mg/d
Child (618 y): PO 1.52 mg/kg/d in divided doses, increase q34d prn (max: 6 mg/kg/d)
- Give drug with food; increases amount of absorption by 20% and appears to decrease incidence of dizziness or light-headedness.
Maintain the same schedule for food-drug intake throughout treatment period to prevent variations in serum concentration.
- Store in tightly closed, light-resistant container at 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS: Drowsiness,
light-headedness, tiredness, dizziness, insomnia
, headache, agitation, impaired memory and speech, disorientation. CV: Hypotension (including orthostatic hypotension),
hypertension, syncope, shortness of breath, chest pain, tachycardia, palpitations, bradycardia, PVCs, ventricular tachycardia
(short episodes of 34 beats). Special Senses:
Nasal and sinus congestion, blurred vision, eye irritation, sweating or clamminess, tinnitus. GI: Dry mouth,
, abdominal distress, nausea, vomiting, dysgeusia, flatulence, diarrhea. Urogenital:
Hematuria, increased frequency, delayed urine flow, early or absent menses, male priapism, ejaculation inhibition. Hematologic:
Skeletal aches and pains, muscle twitches. Skin:
Skin eruptions, rash, pruritus, acne
, photosensitivity. Body as a Whole:
Weight gain or loss.
InteractionsDrug: antihypertensive agents
may potentiate hypotensive effects; alcohol
and other cns depressants
add to depressant effects; may increase digoxin
levels; mao inhibitors
may precipitate hypertensive crisis; ketoconazole, indinavir, ritonavir
may increase levels and toxicity. Herbal: Ginkgo
may increase sedation.
Readily from GI tract. Onset:
12 wk. Peak:
12 h. Distribution:
Distributed into breast milk. Metabolism:
In liver. Elimination:
75% in urine, 25% in feces. Half-Life:
Assessment & Drug Effects
- Monitor pulse rate and regularity before administration if patient has preexisting cardiac disease.
- Note: Adverse effects generally are mild and tend to decrease and disappear after the first few weeks of treatment.
- Monitor children and adolescents for changes in behavior that indicate increased suicidality.
- Observe patient's level of activity. If it appears to be increasing toward sleeplessness and agitation with changes in reality
orientation, report to physician. Manic episodes have been reported.
- Check patient for symptoms of hypotension. If orthostatic hypotension is troublesome, suggest measures to reduce danger of
falling and help patient to tolerate the effects. Discuss with physician; reduction of dose or discontinuation of the drug
may be prescribed.
- Male patient should report inappropriate or prolonged penile erections. The drug may be discontinued.
- Be aware that overdose is characterized by an extension of common adverse effects: Vomiting, lethargy, drowsiness, and exaggerated
anticholinergic effects. Seizures or arrhythmias are unusual.
Patient & Family Education
- Expect therapeutic response to begin in 1 wk; may require 24 wk to reach maximum levels. Adhere to regimen.
- Do not alter dose or intervals between doses.
- Consult physician if drowsiness becomes a distressing adverse effect. Dose regimen may be changed so that largest dose is
- Limit or abstain from alcohol use. The depressant effects of CNS depressants and alcohol may be potentiated by this drug.
- Do not self-medicate with OTC drugs for colds, allergy, or insomnia treatment without advice of physician. Many of these
drugs contain CNS depressants.
- Keep follow-up appointments to permit dose adjustment or discontinuation, as indicated.
- Alert dentist, surgeon, or emergency personnel that drug is being used. Trazodone is discontinued as long as possible prior
to elective surgery.