Trazodone Trazodone - composition, release form, action, use, indications, contraindications - Medicinal reference book

Trazodone
is an antidepressant that belongs to the class of serotonin antagonists/reuptake inhibitors (SSRIs). Along with blocking serotonin reuptake and increasing serotonergic neurotransmission, it strongly blocks serotonin receptors of the 5-HT2 subtype, which explains the low likelihood of sexual side effects, as well as the low likelihood of exacerbation of anxiety, insomnia and nervousness compared to SSRI antidepressants.

Medical action

To date, the principle of action of azone has not been fully studied. Preclinical studies have established that the pharmacological effect is antidepressant. The active substance synthesizes and secretes serotonin (the hormone of joy). When taking the drug, relief of mental and somatic manifestations of the disease is noted.

The drug eliminates anxiety, unreasonable fear, tension, and insomnia. It also relieves the following somatic manifestations:

• Headache;
• Myalgia;
• Heavy heartbeat (rapid rhythm);
• Excessive sweating;
• Frequent urge to urinate.

In neurotic patients, the sleep phase improves. The drug is quickly absorbed by the gastrointestinal tract, so it should not be taken during meals. best in the evening hours.

Pharmacological properties[ | ]

The drug has an antidepressant (thymoanaleptic) effect, combined with an anxiolytic effect. In terms of pharmacological properties and neurochemical action, it differs from typical antidepressants; does not reduce the depressive effect of reserpine, weakens the central effects of phenamine and the peripheral effect of norepinephrine; does not have a noticeable effect on the neuronal uptake of catecholamines, but selectively blocks the uptake of serotonin and has an α-adrenergic blocking effect [1].

Indications for use

The presented antidepressant is quite broad-spectrum and is taken for:

• Depressive syndrome (somatogenic, endogenous, mental, neurotic type);
• Bulimia;
• Kleptomania (for treatment and repeated rehabilitation courses);
• Phobias, panic attacks, which manifest themselves in the form of anxiety, unbridled fear, tension;
• Diabetic neuropathy (to relieve pain).

Trazodone is also used to treat impotence and sexual pathologies. The drug is active in eliminating acute alcohol withdrawal. Migraine is also considered an indication for the use of the drug. Trazodone is used for the prevention and treatment of systematic headaches.

Sometimes urologists prescribe medication to treat sexual dysfunction in men. Trazodone is used to restore libido and potency.

Excerpt describing Trazodone

The attack of the 6th Jaeger ensured the retreat of the right flank. In the center, the action of the forgotten battery of Tushin, who managed to light Shengraben, stopped the movement of the French. The French put out the fire, carried by the wind, and gave time to retreat. The retreat of the center through the ravine was hasty and noisy; however, the troops, retreating, did not mix up their commands. But the left flank, which was simultaneously attacked and bypassed by the superior forces of the French under the command of Lannes and which consisted of the Azov and Podolsk infantry and Pavlograd hussar regiments, was upset. Bagration sent Zherkov to the general of the left flank with orders to immediately retreat. Zherkov smartly, without removing his hand from his cap, touched his horse and galloped off. But as soon as he drove away from Bagration, his strength failed him. An insurmountable fear came over him, and he could not go where it was dangerous. Having approached the troops of the left flank, he did not go forward, where there was shooting, but began to look for the general and commanders where they could not be, and therefore did not convey the order. The command of the left flank belonged by seniority to the regimental commander of the very regiment that was represented at Braunau by Kutuzov and in which Dolokhov served as a soldier. The command of the extreme left flank was assigned to the commander of the Pavlograd regiment, where Rostov served, as a result of which a misunderstanding occurred. Both commanders were very irritated against each other, and while things had been going on on the right flank for a long time and the French had already begun their offensive, both commanders were busy in negotiations that were intended to insult each other. The regiments, both cavalry and infantry, were very little prepared for the upcoming task. The people of the regiments, from soldier to general, did not expect battle and calmly went about peaceful affairs: feeding horses in the cavalry, collecting firewood in the infantry. “He is, however, older than me in rank,” said the German, a hussar colonel, blushing and turning to the adjutant who had arrived, “then leave him to do as he wants.” I cannot sacrifice my hussars. Trumpeter! Play retreat! But things were getting to a point in a hurry. The cannonade and shooting, merging, thundered on the right and in the center, and the French hoods of the Lannes riflemen had already passed the mill dam and lined up on this side in two rifle shots. The infantry colonel walked up to the horse with a trembling gait and, climbing onto it and becoming very straight and tall, rode to the Pavlograd commander. The regimental commanders gathered with polite bows and with hidden malice in their hearts. “Again, Colonel,” said the general, “I cannot, however, leave half the people in the forest.” “I ask you, I ask you,” he repeated, “to take a position and prepare to attack. “And I ask you not to interfere, it’s not your business,” the colonel answered, getting excited. “If you were a cavalryman...” “I’m not a cavalryman, colonel, but I am a Russian general, and if you don’t know this...” “Very well known, Your Excellency,” the colonel suddenly cried out, touching the horse, and turning red and purple. “Would you like to put me in chains, and you will see that this position is worthless?” I don't want to destroy my regiment for your pleasure. - You are forgetting yourself, Colonel. I do not respect my pleasure and will not allow anyone to say this. The general, accepting the colonel's invitation to the tournament of courage, straightened his chest and frowned, rode with him towards the chain, as if all their disagreement was to be resolved there, in the chain, under the bullets. They arrived in a chain, several bullets flew over them, and they stopped silently. There was nothing to see in the chain, since even from the place where they had previously stood, it was clear that it was impossible for the cavalry to operate in the bushes and ravines, and that the French were going around the left wing. The general and the colonel looked sternly and significantly, like two roosters preparing for battle, at each other, waiting in vain for signs of cowardice. Both passed the exam. Since there was nothing to say, and neither one nor the other wanted to give the other a reason to say that he was the first to escape from the bullets, they would have stood there for a long time, mutually testing their courage, if at that time in the forest, almost behind them, there had not been the crackle of guns and a dull merging cry were heard. The French attacked soldiers who were in the forest with firewood. The hussars could no longer retreat along with the infantry. They were cut off from the retreat to the left by a French chain. Now, no matter how inconvenient the terrain was, it was necessary to attack in order to pave a path for ourselves. The squadron where Rostov served, who had just managed to mount the horses, was stopped facing the enemy. Again, as on the Ensky Bridge, there was no one between the squadron and the enemy, and between them, dividing them, lay the same terrible line of uncertainty and fear, as if the line separating the living from the dead. All people felt this line, and the question of whether or not they would cross the line and how they would cross the line worried them. A colonel drove up to the front, angrily answered the officers’ questions and, like a man desperately insisting on his own, gave some kind of order. No one said anything definite, but rumors of an attack spread throughout the squadron. The formation command was heard, then the sabers screeched as they were taken out of their scabbards. But still no one moved. The troops on the left flank, both infantry and hussars, felt that the authorities themselves did not know what to do, and the indecisiveness of the leaders was communicated to the troops. “Hurry, hurry,” thought Rostov, feeling that the time had finally come to experience the pleasure of attack, about which he had heard so much from his comrades of the hussars. “With God, you bastards,” Denisov’s voice sounded, “g’ysyo, mag’sh!” In the front row the rumps of horses swayed. The rook pulled the reins and set off himself. On the right, Rostov saw the first ranks of his hussars, and even further ahead he could see a dark stripe, which he could not see, but considered the enemy. Shots were heard, but in the distance. - Increase the trot! - a command was heard, and Rostov felt his Grachik giving in with his hindquarters, breaking into a gallop. He guessed his movements in advance, and he became more and more fun. He noticed a lone tree ahead. At first this tree was in front, in the middle of that line that seemed so terrible. But we crossed this line, and not only was there nothing terrible, but it became more and more fun and lively. “Oh, how I will cut him,” thought Rostov, clutching the hilt of the saber in his hand. - Oh oh oh ah ah!! - voices boomed. “Well, now whoever it is,” thought Rostov, pressing Grachik’s spurs in, and, overtaking the others, released him into the entire quarry. The enemy was already visible ahead. Suddenly, like a wide broom, something hit the squadron. Rostov raised his saber, preparing to cut, but at that time the soldier Nikitenko, galloping ahead, separated from him, and Rostov felt, as in a dream, that he continued to rush forward with unnatural speed and at the same time remained in place. From behind, the familiar hussar Bandarchuk galloped up at him and looked angrily. Bandarchuk's horse gave way, and he galloped past. "What is this? Am I not moving? “I fell, I was killed...” Rostov asked and answered in an instant. He was already alone in the middle of the field. Instead of moving horses and hussars' backs, he saw motionless earth and stubble around him. Warm blood was underneath him. “No, I’m wounded and the horse is killed.” The rook stood up on his front legs, but fell, crushing the rider's leg. Blood was flowing from the horse's head. The horse was struggling and could not get up. Rostov wanted to get up and fell too: the cart caught on the saddle. Where ours were, where the French were, he didn’t know. There was no one around. Freeing his leg, he stood up. “Where, on which side was now the line that so sharply separated the two armies?” – he asked himself and could not answer. “Has something bad happened to me? Do such cases happen, and what should be done in such cases? - he asked himself getting up; and at that time he felt that something unnecessary was hanging on his left numb hand. Her brush was like someone else's. He looked at his hand, searching in vain for blood on it. “Well, here are the people,” he thought joyfully, seeing several people running towards him. “They will help me!” Ahead of these people ran one in a strange shako and a blue overcoat, black, tanned, with a hooked nose. Two more and many more were running behind. One of them said something strange, non-Russian. Between the rear similar people, in the same shakos, stood one Russian hussar. They held his hands; his horse was held behind him.

Mode of application

The tablets are designed for oral administration. You need to take the product before going to bed. 100 mg maximum starting dose. At the beginning of therapy, the daily dose can be divided into three doses. The dosage can be increased every 3-4 days by 50 mg, however, the highest level is 450 mg per day.

In a hospital setting, an injection form of the drug is used, which is administered intramuscularly and intravenously. Maintenance therapy for depressive conditions reaches a dosage of 0.15 grams per day. This is sufficient for mild deviations. Elderly people are prescribed Trazodone in the amount of 0.3 grams per day.

Should be used with caution in children. The dosage for children over six is ​​1.5-2 mg of the substance per 1 kg of weight. The optimal and adaptive amount of the product is calculated strictly by a specialist.

The exact dosage can only be determined by the attending physician, taking into account the degree and development of the disease.

Trazodone: instructions for use, reviews, price and analogues – Suppressed

Antidepressants can not only relieve increased anxiety, but also eliminate the effects of prolonged stress.

A quick and effective result can be achieved with proper selection of the drug, which is only possible for a qualified specialist.

Radar

The antidepressant Trittico is included in the register of medicines of the Russian Federation.

Basic system information contains the following data:

• trade name – Trittiko;
• registration number – P N015703/01;
• INN – Trazodone;
• ATX code – N06AX05.

The medicine is dispensed if there is a prescription sheet drawn up in Latin.

Pharmacology

The medicine is a thiazolopyridine derivative.

It is used in therapy to obtain the following effects:

• sedative;
• thymoleptic;
• muscle relaxant;
• anxiolytic.

This excludes such manifestations as:

• neuronal uptake of norepinephrine and dopamine;
• anticholinergic effect;
• MAO inhibition;
• weight gain.

Therapy, including taking Trittico, helps eliminate a number of problems:

• insomnia;
• unreasonable fears;
• excessive irritability;
• strong heartbeat;
• myalgia;
• frequent urination;
• increased sweating;
• headache.

Average statistical indicators of therapeutic effect:

• after 3-7 days of use – in 50% of patients;
• after 2-4 weeks of treatment – ​​in 25% of patients.

Price

In chain pharmacies and online stores, the product can be purchased at a price of 577 - 884 rubles . When purchasing, you must present a prescription certified by a doctor.

You can check the cost and availability of the drug on reference sites.

More favorable prices are offered by online pharmacies, where it is possible to deliver antidepressants to your home by courier service.

Indications for use

Trazodone hydrochloride is used to treat various forms of depression:

• somatogenic;
• endogenous;
• neurotic;
• psychotic.

It is rational to include an antidepressant in complex treatment if at least four characteristic signs of a depressive state are present:

• loss or increase in appetite;
• sleep disturbance;
• inhibition expressed in psychomotor or mental activity;
• loss of interest in what is happening around, sex life, desire to take care of yourself and loved ones;
• physical weakness;
• guilt;
• rapid fatigue, which interferes with work activity;
• low concentration, forgetfulness, absent-mindedness;
• manifestation of various phobias.

TRAZODONE

trazodone names

• Generic Name: trazodone
• Brand Names: Desyrel, Desyrel Dividose, Oleptro
• Last updated: December 13, 2020
• What is trazodone?

Trazodone is an antidepressant. This affects chemicals in the brain that may be out of balance in people with depression.

INDICATIONS:

Trazodone is used to treat major depressive disorder. It may help improve mood, appetite and energy levels, and reduce anxiety and insomnia associated with depression.

Trazodone helps restore the balance of a certain natural chemical (serotonin) in the brain.

Before taking this medicine

Do not use trazodone if you have used an MAO inhibitor in the last 14 days. A dangerous drug interaction may occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

drug trazodone

1. After you stop taking trazodone, you must wait at least 14 days before starting to take an MAOI.
2. With caution if there were:
3. liver or kidney diseases;
4. heart disease or recent heart attack;
5. bleeding or blood clotting disorder;
6. seizures or epilepsy;
7. narrow-angle glaucoma;
8. long QT syndrome;
9. drug abuse or thoughts of suicide; or
10. bipolar disorder (manic depression).

USE IN PREGNANCY AND BREAST-FEEDING

Taking an SSRI antidepressant during pregnancy can cause serious lung problems or other complications in the baby. However, you may experience a relapse of depression if you stop taking your antidepressant.

Trazodone is not approved for use by persons under 18 years of age.

trazodone tablets

METHOD OF APPLICATION AND DOSES:

• Usual Adult Dose for Depression
• Initial dose: 150 mg orally per day in divided doses; this may be increased by 50 mg orally per day every 3-4 days
• Maximum dose:
• -Hospitals: 600 mg/day
• – outpatients: 400 mg/day
• What happens if you miss a dose?

Take the medicine as soon as possible, but skip the missed dose if it is almost time for the next dose. Do not take two doses at one time.

trazodone use reviews

1. What happens if you overdose?
2. An overdose of trazodone can be fatal if it is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).
3. Symptoms of overdose may include severe drowsiness, vomiting, painful or prolonged penile erection, fast or rapid heartbeat, seizures (blackouts or convulsions), or slow or stopping breathing.

What should I avoid while taking Trazodone?

• alcohol. Dangerous side effects or death may occur.
• driving or engaging in hazardous activities until you know how trazodone may affect you. Your reactions may be impaired.
• Try not to get up too quickly from a sitting or lying position, otherwise you may feel dizzy.
• Check with your doctor before taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with this mesicin may cause bruising or bleeding.

medicine trazodone

SIDE EFFECTS :

- signs of an allergic reaction to trazodone: urticaria; labored breathing; swelling of the face, lips, tongue, or throat.

- painful erection of the penis that lasts 6 hours or longer. This is a medical emergency that can result in a serious condition that must be corrected with surgery.

• - changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts of suicide or harming yourself.
• - fast or pounding heartbeat, fluttering in the chest, shortness of breath, and sudden dizziness (as if you might pass out);
• -unusual thoughts or behavior;
• - blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• - chest pain or pressure, tightness in the neck or jaw, sweating, pain spreading to the arm or shoulder;
• - low sodium levels in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• - severe nervous system reaction - very tight (stiff) muscles, high fever, sweating, confusion, fast or uneven heartbeat, tremors, feeling like you might pass out.
• - symptoms of serotonin syndrome such as: agitation, hallucinations, fever, sweating, trembling, rapid heartbeat, muscle stiffness, twitching, loss of coordination, nausea, vomiting or diarrhea.

trazodone instructions price

1. Common side effects of trazodone may include:
2. drowsiness, dizziness, fatigue;
3. edema;
4. weight gain or loss;
5. vision changes;
6. diarrhea, constipation;
7. dry mouth, altered sense of taste.
8. Nervous system
9. Very common (10% or more): drowsiness (up to 41%), dizziness (up to 28%), lightheadedness (up to 28%), headache (up to 20%)
10. gastrointestinal
11. Very common (10% or more): dry mouth (up to 34%), nausea (up to 13%), vomiting (up to 13%)
12. cardiovascular
13. Very common (10% or more): hypertension (up to 20%)
14. eyepiece
15. Very common (10% or more): visual impairment (up to 15%)
16. psychiatric
17. Very common (10% or more): nervousness (up to 15%)
18. metabolic
19. Regular (1% to 10%): weight gain, weight loss
20. respiratory
21. Common (1% to 10%): Nasal congestion, stuffy nose
22. dermatological
23. Common (1% to 10%): skin condition
24. urogenital

Source: //glpni.ru/fobii/trazodon-instruktsiya-po-primeneniyu-otzyvy-tsena-i-analogi.html

Contraindications

Since the active substance quickly penetrates into bile, pregnant women and mothers during breastfeeding should not take the drug in breast milk and saliva. Trazodone should also not be taken under the following circumstances:

• Age up to six years;
• Alcohol intoxication;
• Intoxication with sleeping pills;
• Sensitivity to components;
• Fructose/sucrose intolerance.

Since the effect of the drug has not been fully studied, it is recommended that children and adolescents under 18 years of age not take the drug. The medication is prescribed only when clearly needed by a doctor.

Pharmacokinetics[ | ]

Tmax after oral administration is from 0.5 to 2 hours. Taking trazodone with food slows down the rate of absorption from the gastrointestinal tract, reduces Cmax in blood plasma and increases Tmax. Penetrates through histohematic barriers, as well as into tissues and liquids (bile, saliva, breast milk). Plasma protein binding is 87-96%. Metabolized in the liver, the active metabolite is 1-m-chlorophenylpiperazine. T1/2 is 3-6 hours, in the second phase - 5-9 hours. About 75% is subsequently excreted through the kidneys in the urine. About 20% is removed with bile. Complete liberation of the body from the active substance and its metabolites is observed 98 hours after administration.

Side effects

Basically, the risk of side effects is observed when the dosage of the drug is exceeded. However, the medication has a number of side effects, manifested in the form of:

• Headache, psychosis;
• Weakness, unpleasant odor and taste in the mouth;
• Caries;
• Dry mucous membranes;
• Hematuria, menstrual irregularities;
• Liver pathologies;
• Hypotension;
• Tremors, convulsive states;
• Confusion;
• Excessive sexual excitability.

Such conditions are quite rare, but people with hypotensive syndrome need to take the drug with extreme caution. If any symptoms are detected, you should notify your doctor to reduce the dosage of the drug or completely stop therapy.

Overdose

Failure to follow the instructions for use of the drug may cause vomiting, dizziness, drowsiness, convulsions, seizures similar to epilepsy. In addition, exceeding the dose of Trazodone provokes changes in the electrocardiogram, increasing the occurrence of side effects, including respiratory arrest. If signs of overdose are detected, the patient is given activated charcoal or another enterosorbent, forced diuresis is performed, and symptomatic therapy is prescribed. Trazodone has no specific antidote.

Trazodone cost: where to buy

The drug is sold in cardboard packaging in the amount of 10 tablets of 150 mg. You can purchase the medication at any pharmacy chain; this type of antidepressant is over-the-counter. Therefore, you can buy it without a specialist prescription. The cost of Trazodone is on average 1000 rubles. In different pharmacies in Moscow, the cost varies between 200-300 rubles.

Notes

1. Directory VIDAL. - M.: AstraPharmServis, 2001. - S. Z-360. — ISBN 5-89892-021-4.
2. John A. Thomas
   

   Secondary amines	Desipramine* • Nortriptyline* • Protriptyline
   Atypical tricyclics	Tianeptine • Amineptine
   Tetracyclics	Maprotiline • Amoxapine
   Other tricyclics	Pipofezine • Lofepramine* • Dibenzepine* • Iprindole • Melitracene • Butriptyline* • Dosuleptin • Dimethacrine • Quinupramine
   Selective reuptake inhibitors
   Serotonin (SSRI)	Fluoxetine • Sertraline • Paroxetine • Citalopram • Escitalopram • Alaproclat • Fluvoxamine • Etoperidone • Zimelidine • Dapoxetine • Indalpin • Vilazodone
   Serotonin and norepinephrine (SSRI)	Venlafaxine • Desvenlafaxine • Duloxetine • Milnacipran • Levomilnacipran
   Norepinephrine (SNRI)	Reboxetine* • Atomoxetine
   Norepinephrine and dopamine (SSRI)	Bupropion
   Monoamine oxidase inhibitors
   Irreversible nonselective	Isocarboxazid • Nialamid • Phenelzine • Tranylcypromine • Iproniazid* • Iprocloside
   Reversible selective type A	Moclobemide • Toloxatone • Pyrazidol • Befol • Incazan • Tetrindole
   Monoamine receptor agonists
   Noradrenergic and specific serotonergic antidepressants (NaSSA) (tetracyclics)	Mirtazapine • Mianserin
   Specific serotonergic antidepressants (SSA)	Trazodone • Nefazodone
   Other groups of antidepressants
   Melatonergic	Agomelatine
   Other antidepressants	Vortioxetine • Oxytriptan • L-Tryptophan • Nomifensine* • Minaprine* • Bifemelan • Viloxazine* • Oxaflosan • Medifoxamine • Pivagabine • Gepirone • Feprosidnine • S-Adenosylmethionine • Hypericin
   Data on medicinal products are presented in accordance with the register of registered drugs and TKFS dated October 15, 2008 (* - the drug is withdrawn from circulation) [www.regmed.ru/search.asp Search in the drug database]. FGU NC ESMP Roszdravnadzor of the Russian Federation (10/28/2008). Retrieved November 12, 2008.

Patient reviews

It is worth noting that the drug Azona or Trittico is in demand among people with identified depressive conditions. With the correct dosage, the medication works successfully and reduces the symptoms of diseases. Patients note increased sexual desire as one of the “good” side effects. Men note that taking Trazodone eliminates potency and libido disorders.

The drug has proven itself well in the antidepressant segment, but the most negative aspect, according to patients, is the high price of the drug.

Interactions[ | ]

It is not combined with irreversible MAOIs[11] (when combined with MAOIs, the toxicity of each drug may increase[14]:604), with buspirone. It is not recommended to combine with fluoxetine, paroxetine, haloperidol, thioridazine. Increases digoxin concentration[11]. Changes the effect of warfarin, reduces the effect of M-cholinomimetics. Phenobarbital and cisapride reduce the effect of trazodone; phenothiazine derivatives and cimetidine can enhance its effect. The combination of trazodone with clozapine leads to a toxic effect on the central nervous system; when combined with paroxetine or nicardipine, the effect and toxicity of each drug may be enhanced [14]: 603-604. When taking trazodone together with drugs that depress the central nervous system or alcohol, a synergistic effect is possible [8]; in particular, when used together with anxiolytics and hypnotics, the sedative effect is enhanced. Trazodone interferes with the therapeutic effect of antiepileptic drugs[15].

The combined use of trazodone with SSRI antidepressants can cause serotonin syndrome[16]. When combined with opioid analgesics, antihistamines, and some antidepressants, severe drowsiness occurs. When combined with antihypertensive drugs, the risk of orthostatic hypotension increases; when combined with clonidine, clonidine-induced hypotension decreases[14]:603-604. Combined use with pimozide or flecainide may lead to an increased risk of arrhythmia, and with beta-blockers or digitalis glycosides - to severe bradycardia[14]:603-604.