Trazadone (Desyrel)

Antidepressant (Low dose: antagonist at serotonin 5-HT2 and norepinephrine alpha-1 receptors; antidepressant dose: serotonin reuptake inhi

Dosing

150-300/night for depression (start 50 mg/night, raise to 150 over 7-14 days; raising slowly improves response).

Management

Warn of fatigue, hypotension. Rare priapism, cardiac conduction delays. Raise 3-5 fold if taking carbamazepine. Caution when adding to CYP2D6 inhibitors (eg fluoxetine, fluvoxamine, paroxetine, duloxetine, bupropion) as they can raise trazodone’s metabolite (mCPP) causing mood problems.

EMR Text