Trazodone

When ATH:
N06AX05

Characteristic.

Derivative thiazolopyridine; the chemical structure is not a tricyclic, tetracyclic antidepressants or other groups. White crystal odorless powder, soluble in water.

Pharmacological action.
Antidepressant.

Application.

Depressive states of various etiologies (Endogenous, Psychotic, neurotic, somatogenic and others.) with severe anxiety, strength; pain neuralgia, agorafoʙii, Alcohol withdrawal state, drug dependence to benzodiazepines, decreased libido, impotence.

Contraindications.

Hypersensitivity, myocardial infarction (early recovery period), ventricular arrhythmia, arrythmia, tachycardia, liver and / or kidney failure, pregnancy, lactation, Age to 6 years.

Restrictions apply.

Arterial hypertension (It may require adjustment of doses of antihypertensive drugs), priapism history, Age to 18 years.

Pregnancy and breast-feeding.

Contraindicated in pregnancy. At the time of treatment should abandon breastfeeding.

Side effects.

From the nervous system and sensory organs: fatiguability, weakness, headache, dizziness, insomnia, drowsiness, excitation, psychosis, hypomania, hallucinations, tremor, vellication, large seizures (great evil), afazija, ataxia, akathisia, dyskinesia, paresthesia, confusion, syncope, blurred vision, diplopia.

Cardio-vascular system and blood (hematopoiesis, hemostasis): hypotension, incl. orthostatic; Atrial fibrillation, Arrhythmia (incl. Rituals- and bradycardia, ectopic ventricular beats), congestive heart failure, leukocytosis or leukopenia, neutropenia (usually insignificant), gemoliticheskaya anemia, metgemoglobinemiâ.

From the digestive tract: increased appetite, dry and unpleasant taste in the mouth, hyperptyalism, caries, periodontal disease tissue, oral candidiasis, nausea, vomiting, flatulence, diarrhea, constipation, cholestasis, increase in bilirubin and amylase in serum, jaundice.

With the genitourinary system: urinary retention, increased urination, hematuria, premature menstruation, girsutizm, increased libido, priapism, impotence, retrograde ejaculation.

Allergic reactions: skin rash, hives.

Other: myalgia, chest pain, alopecia, psoriasis, swelling.

Cooperation.

Unlike typical antidepressants, It does not reduce the effects of reserpine deprimiruyuschie, weakens the central action of amphetamine and peripheral-norepinephrine. Potentiates the effect of funds, CNS depressants (incl. ʙarʙituratov, tricyclic antidepressants, antihistamines, klonidina, alcohol), anticholinergic agents, and muscle relaxants. When concomitantly with antihypertensive drugs increases the risk of orthostatic hypotension. It weakens the effect of psychostimulants. Increases the plasma concentration of digoxin and phenytoin. Should not be used concurrently with MAO inhibitors.

Overdose.

Symptoms: nausea, vomiting, drowsiness, dizziness, low blood pressure, incoordination, priapism, epileptiform seizures, ECG changes, respiratory arrest, weighting of adverse reactions.

Treatment: gastric lavage, diurez, administration of activated charcoal, maintaining vital functions, simptomaticheskaya therapy. No specific antidote.

Dosing and Administration.

/ M, I /. Inside, during or immediately after a meal, 2-3 hours (2/3 daily dose — before bedtime).

Adults: 150 mg / day, if necessary, increase the dose to 50 mg/day every 3-4 days until a therapeutic effect. The maximum daily dose on an outpatient basis — 450 mg, in stationary- 600 mg. Supporting dose in mild forms of depression — 150 mg / day, When moderate to severe — 300 mg / day. For the elderly and handicapped patients initial dose 75 mg / day, if necessary, it can be increased to 300 mg / day. Children 6-18 years: 1,5-2 mg/kg/day, if necessary, increase the dose to 6 mg / kg / day.

Violations of libido: 50 mg / day. Impotence: 200 mg/day with monotherapies, 50 mg/day as part of an integrated therapy. Benzodiazepine dependence: stepwise reducing the dose of benzodiazepines on 1/4 or 1/2 tablets, simultaneously added 50 mg of trazodone, during 3 Sun, further reduce the dose of benzodiazepines continue until canceled, then reduce the dose to the trazodona 50 mg / day every 3 Sun. Premedication: / m, I / 50 mg.

Precautions.

During treatment, periodic blood count (for early detection lejko- and neutropenia), ECG monitoring is advisable in patients with cardiovascular disease. Careful monitoring of patients with suicidal tendencies, particularly in the first weeks of treatment. Treatment immediately cease the development of priapism, expressed neutrons- and leukopenia; in other cases, the abolition of the drug should be gradual. During treatment should avoid drinking alcohol. Be wary of during the drivers of vehicles and people, activities are associated with high concentration of attention.

Cooperation