Med. praxi. 2025;22(2):94-97 | DOI: 10.36290/med.2025.017

The use of trazodone in GP practice

MUDr. Juraj Tkáč

Poliklinika Dům zdraví, Ambulance ADIKTA, s. r. o., Jihlava

Depressive and anxiety disorders represent a significant burden on primary care, and demand for effective and well-tolerated treatments continues to grow. This article summarises current knowledge of trazodone, a multifunctional antidepressant from the SARI group that combines serotonin reuptake inhibition with HT₂A receptor 5 antagonism. This review focuses on the pharmacodynamics and pharmacokinetics of the drug, its antidepressant, anxiolytic, and sedative properties as well as its potential neuroprotective effects. Clinical data demonstrate comparable efficacy to SSRI/SNRIs in the treatment of major depressive disorder and demonstrate benefit in generalized anxiety disorder, insomnia, and chronic neuropathic pain. Low doses (25-100 mg) are used to improve sleep, while the antidepressant effect requires titration to 150-300 mg daily. The relatively favourable sexual side effect profile and low anticholinergic activity make trazodone suitable for elderly polymorbid patients. The article discusses the practicalities of prescribing in the general practitioner's office and options for combination with other psychopharmaceuticals. It also highlights key safety risks, particularly orthostatic hypotension, QT interval prolongation, and rare priapism. Proper dose selection, gradual titration, and patient education are essential to maximize the therapeutic benefit and minimize the risks of this treatment.

Keywords: trazodone, depression, anxiety disorders, insomnia, general practitioner, SARI antidepressants.

Received: January 28, 2025; Revised: March 11, 2025; Accepted: March 18, 2025; Published: April 30, 2025  Show citation