Does trazodone have a role in palliating symptoms?
BACKGROUND
Trazodone is a unique antidepressant, which blocks the postsynaptic serotonin (5-HT) receptors, 5-HT(2A) and 5-HT(2C), and weakly inhibits presynaptic 5-HT transporters.


CONCLUSIONS
Trazodone is well-absorbed by the mouth and is metabolized by three cytochromes: CYP1A2, CYP2D6, and CYP3A4. Clinical benefits include reduced insomnia in those depressed and/or on antidepressants. Pain may be relieved by mechanisms similar to venlafaxine. Delirium unresponsive to neuroleptics has been reported to respond to trazodone. Drug interactions are a risk due to cytochrome metabolism.


CONCLUSIONS
Trazodone has a unique pharmacology, which may be an advantage in palliating symptoms; however, little evidence is available through cohort or randomized trials to give guidance to its use.
Davis
Mellar P
MP
The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic Foundation, M76, Cleveland, OH 44195, USA. davism@ccf.org
D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D004347:Drug Interactions; D005473:Fluoxetine / Q000009:adverse effects; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology / Q000523:psychology; D010166:Palliative Care / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000209:etiology; D014196:Trazodone / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D014196:Trazodone