title: Trazodone utilization among the elderly in Spain. A population based study.
abstract: BACKGROUND
  Trazodone was authorized for the treatment of depression in the 1970s. Several additional therapeutic uses have been proposed due to its heterogeneous mechanism. This study aims to determine the use of trazodone in the elderly in Spain.
  
  
  METHODS
  A nationwide, longitudinal and descriptive analysis was conducted using data from patients aged >65 years with a first prescription of trazodone during the period 2002-2011. Information on dose, comorbidities and relevant co-medication was gathered from the Spanish Primary Care database BIFAP. Incidence rates of trazodone use per 10,000 person-years were calculated by sex and age.
  
  
  RESULTS
  A total of 11,766 patients receiving a first prescription of trazodone were included. The incidence rate of trazodone use was 47.2 (95% CI: 46.33-48.04) per 10,000 person-years. An increasing trend in the use of trazodone was observed (5-fold increase in 2011 as compared to 2002). The most common therapeutic indications were: depression (21.41%), Alzheimer/dementia (20.36%), sleep disorders (16.22%), and anxiety disorder (8.91%). The median dose was 100mg/day. The use of trazodone concomitantly with interacting medicines was frequent: anti-hypertensives (53.60%), and CNS depressors (59.32%).
  
  
  CONCLUSIONS
  Trazodone use is increasing in elderly patients, and a high proportion of use in non-approved indications was observed. Trazodone is not being used at high doses, but interacting medicines were frequent, and it may pose additional risks for elderly patients.
authors.affiliation: Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain. Electronic address: dmacias.sg@gmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Macías Saint-Gerons
authors.affiliation: Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Huerta Álvarez
authors.affiliation: Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: García Poza
authors.affiliation: Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Montero Corominas
authors.affiliation: Area of Budgetary Stability, Ministry of Finance and Public Administrations, Madrid, Spain.
authors.forename: César
authors.initials: C
authors.lastname: de la Fuente Honrubia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy; D016208:Databases, Factual; D003704:Dementia / Q000188:drug therapy; D003863:Depression / Q000188:drug therapy; D004334:Drug Administration Schedule; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011320:Primary Health Care; D012893:Sleep Wake Disorders / Q000188:drug therapy; D013030:Spain; D014196:Trazodone / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014196:Trazodone
keywords: BIFAP; Drug utilisation study; Estudio de utilización; Trazodona; Trazodone