Trazodone Is Not as Effective as OtherAntidepressants in Treating a Patient withMajor Depressive Disorder

Trazodone在治療重度憂鬱症病人的療效是不如其他抗鬱劑

10.29478/TJP.201212.0009

吳佳慶(Kah Kheng Goh)；譚永健(Weng-Kin Tam)；沈武典(Winston W. Shen)

antidepressant therapy ； suicide ； venlafaxine ； bupropion

台灣精神醫學

26卷4期（2012 / 12 / 01）

311 - 315

英文

Background: Trazodone in clinical use is ineffective because of its sedation to let patient receive an adequate dose for treating a patient with major depressive disorder. We are report a case report to demonstrate this clinical efficacy issue in the treatment with trazodone. Case Report: A 83-year old male Taiwanese patient had suffered from MDD for six months. He did not response to the treatment of trazodone 150 mg/day for four months, but consequently, he responded to the treatment of milnacipran 100 mg/day or mirtazapine 30 mg/day. Conclusion: Psychiatrists in Taiwan should be alert to the fact that trazodone is not as effective as other antidepressants, and that trazodone should not be prescribed as a single antidepressant in treating an MDD patient.

1. American Psychiatric Association(2010).Practice Guideline for the Treatment of Patients with Major Depressive Disorder.Arlington, Virginia, USA:American Psychiatric Association.
2. Chong, M. Y.(2012).Prescribing for elderly depression: excessive or inadequate?.Asia-Pacific Psychiatry,4(Suppl I),50-1.
3. Cunningham, L. A.,Borison, R. L.,Carman, J. S.(1994).A comparison of venlafaxine, trazodone, and placebo in major depression.J Clin Psychopharmacol,14,99-106.
4. Haria, M.,Fitton, A.,McTavish, D.(1994).Trazodone: a review of its pharmacology, therapeutic use in depression and therapeutic potential in other disorders.Drugs Aging,4,331-55.
5. Kinney, G. G.,Griffith, J. C.,Hudzik, T. J.(1998).Antidepressant-like effects of 5-hydroxytryptamine1A receptor agonists on operant responding under a response duration differentiation schedule.Beh Pharmacol,9,309-18.
6. Marek, G. J.,McDougle, C. J.,Price, L. H.,Seiden, L. S.(1992).A comparison of trazodone and fluoxetine: implications for a serotonergic mechanism of antidepressant action.Psychopharmacology,109,2-11.
7. Mendelson, W. B.(2005).A review of the evidence for the efficacy and safety of trazodone in insomnia.J Clin Psychopharmacol,66,469-76.
8. Shen, W. W.(2011)。Clinical Psychopharmacology。Taipei Ho-Chi Publishing Company。
9. Watanabe, N.,Omori, I. M.,nakagawa, A.(2010).Safety reporting and adverse-event profile of mirtazapine described in randomized controlled trials in comparison with other classes of antidepressants in the acute-phase treatment of adults with depression: Systematic review and meta-analysis.CNS Drugs,24,35-53.
10. Weisler, R. H.,Johnston, J. A.,Lineberry, C. G.,Samara, B.,Branconnier, R. J.,Billow, A. A.(1994).Comparison of bupropion and trazodone for the treatment of major depression.J Clin Psychopharmacol,14,107-9.
11. Wu, C. S.,Shau, W. Y.,Chan, H. Y.,Lee, Y. C.,Lai, Y. J.,Lai, M. S.(2012).Utilization of antidepressant in Taiwan: a nationwide population-based survey from 2000-2009.Pharmacoepidemiol Drug Safety,21,980-8.
12. Wu-Chou, A. I.,Shen, W. W.(2012).Complex behaviors related to zolpidem: an analysis of published clinical case from Taiwan.Journal of Experimental and Clinical Medicine,4,113-8.