Another 68% of patients without depression and with insomnia received a low-dose trazodone regimen, and 64% of patients without neither depression nor insomnia received the low-dose regimen. Investigators described the trazodone dosing patterns between patients with and without insomnia as “statistically significantly different” ( P <.001).Ī majority of patients (61%) with depression and concomitant insomnia receiving trazodone were prescribed a dose <150 mg daily-deemed a low dose. Among the trazodone arm receiving it for insomnia, more than half (55%) had a concurrent depression diagnosis 53% of patients without insomnia receiving trazodone had a depression diagnosis. Investigators observed 113,557 patients receiving trazodone from the full cohort mean patient age was 49 years old, and two-thirds (66%) were female.Īmong the trazodone prescriptions, 40% were written for patients with an insomnia diagnosis. The cohort included 1.4 million eligible adults, of whom approximately 310,000 had an insomnia diagnosis and more than half (approximately 170,000) were receiving medical care for the condition. Trazodone prescription patterns were assessed in adult patients with and without insomnia. The large-scale cohort included patients aged ≥18 years old assessed between October 2015 and March 2020. Their cohort included patients from a US primary care claims database including medical and pharmacy data from the HealthVerity dataset. The team sought to interpret real-world prescribing patterns for the longtime antidepressant in the context of insomnia disorder, versus use in patients without the sleep condition. “It is often prescribed off-label to treat insomnia, typically at doses below 150mg daily, despite Clinical Practice Guidelines recommendations against use of trazodone treatment for insomnia,” McCall and colleagues wrote. However, one of its most common off-label uses, is against the most recent recommendation of the American Academy of Sleep Medicine’s clinical practice guidelines, among others. Branded in the US as Oleptro, the oral agent is a derivative of trazolopyridine that benefits depressive disorder. Trazodone was approved by the FDA in 1981 for the treatment of depressive disorder at 150-400 mg daily doses. Led by William Vaughn McCall, MD, professor and chairman of the department of psychiatry and health behavior at Augusta University, investigators noted recent trends in use of trazodone even buck against guideline-directed care of depression and other neuropsychiatric conditions. In new real-world data presented at the American Psychiatric Association (APA) 2022 Annual Meeting last month, a team of US investigators reported that trazodone is a popular prescription outside its indicated use and dosage set by the US Food and Drug Administration (FDA) 4 decades ago as an antidepressant. Antidepressant and sedation therapy trazodone is used frequently for off-label treatment of neuropsychiatric diagnoses including insomnia and anxiety-and infrequently at its indicated dose, according to new findings.
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