Reasons to use trazodone XR/CR Review article

Article Sidebar

Requires Subscription PDF (Język Polski)


Published: Jun 30, 2025
DOI: https://doi.org/10.24292/01.MF.0225.06
Keywords:
depression, trazodone, insomnia, antidepressive treatment

Main Article Content

Dominika Dudek
Katedra Psychiatrii, Klinika Psychiatrii Dorosłych, Uniwersytet Jagielloński – Collegium Medicum w Krakowie

Abstract

Depression is one of the leading causes of disability worldwide, and standard selective serotonin reuptake inhibitors treatment often does not lead to full improvement, especially regarding insomnia, anhedonia, or sexual dysfunction, and sometimes even worsens these symptoms. Trazodone stands out due to its unique, dose-dependent mechanism of action, combining antagonism of 5-HT2A/2C receptors, blockade of α1, H1, and α2 receptors, and inhibition of serotonin reuptake, enabling versatile clinical use. At low doses, trazodone has a sedative effect and improves sleep quality, while at higher doses it exhibits strong antidepressant and anxiolytic effects. The availability of controlled-release (CR) and extended-release (XR) formulations allows for convenient dosing and better tolerability, which is important in depression therapy. Trazodone is especially recommended for patients with depression accompanied by insomnia, improving sleep architecture without risk of dependence. Additionally, it benefits patients experiencing sexual dysfunction often caused by selective serotonin reuptake inhibitors by reducing symptom severity. The drug may also be used in patients with depression and metabolic disorders due to a more favorable metabolic profile compared to other antidepressants. All these features make trazodone XR/CR a valuable therapeutic option in treating depression, both as monotherapy and as adjunct therapy.

Article Details

How to Cite
Dudek, D. (2025). Reasons to use trazodone XR/CR. Medycyna Faktow (J EBM), 18(2(67), 204-209. https://doi.org/10.24292/01.MF.0225.06
Issue
Vol 18 No 2(67) (2025)
Section
Articles

Copyright © by Medical Education. All rights reserved.

References

1. Marx W, Penninx BWJH, Solmi M et al. Major depressive disorder. Nat Rev Dis Primers. 2023; 9(1): 44.
2. Marasine NR, Sankhi S, Lamichhane R et al. Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review. Biomed Res Int. 2021; 2021: 6699028.
3. Jing E, Straw-Wilson K. Sexual Dysfunction in Selective Serotonin Reuptake Inhibitors (SSRIs) and Potential Solutions: A Narrative Literature Review. Ment Health Clin. 2016; 6: 191.
4. Wichniak A, Wierzbicka A, Walecka M et al. Effects of Antidepressants on Sleep. Curr Psychiatry Rep. 2017; 19: 63.
5. Jarema M, Dudek D, Landowski J et al. Trazodon – lek przeciwdepresyjny: mechanizm działania i miejsce w leczeniu depresji. Psychiatria Polska. 2011; 45: 611-25.
6. Stahl SM. Mechanism of action of trazodone: a multifunctional drug. CNS Spectr. 2009; 14(10): 536‑46.
7. Siwek M. Dekalog leczenia depresji. ITEM Publishing, Warszawa 2024: 180.
8. Fagiolini A, Comandini A, Catena Dell’Osso M et al. Rediscovering trazodone for the treatment of major depressive disorder. CNS Drugs. 2012; 26(12): 1033‑49.
9. Mendelson WB. A review of the evidence for the efficacy and safety of trazodone in insomnia. J Clin Psychiatry. 2005; 66(4): 469‑76.
10. Siwek M, Gorostowicz A, Chrobak AA et al. TED – trazodone efficacy in depression: a naturalistic study on the efficacy of trazodone in an extended- release formulation compared to SSRIs in patients with a depressive episode – preliminary report. Brain Sci. 2023; 13: 86.
11. Siwek M, Chrobak A, Krupa AJ et al. TED (Trazodone Effectiveness in Depression): efektywność trazodonu o przedłużonym uwalnianiu u pacjentów z niezadowalającą odpowiedzią na leczenie SSRI. Psychiatr. Pol. 2025; 59(1): 7-24.
12. Cubała W, Landowski J. Spektrum zastosowań klinicznych trazodonu. Psychiatria. 2011; 8: 1-6.
13. Montejo AL, Llorca G, Izquierdo JA et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. J Clin Psychiatry. 2001; 62(Suppl 3): 10‑21.
14. Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009; 29(3): 259‑66.
15. Clayton AH, Montejo AL. Major depressive disorder, antidepressants, and sexual dysfunction. J Clin Psychiatry. 2006; 67(Suppl 6): 33‑7.
16. Balon R. Sexual dysfunction associated with antidepressant medications: clinical features and management. Psychiatr Clin North Am. 2007; 30(1): 39‑53.
17. 1Montague DK, Jarow J, Broderick GA et al. American Urological Association guideline on the management of priapism. J Urol. 2003; 170(4 Pt 1): 1318‑24.
18. Butnoriene J, Bunevicius A, Norkus A et al. Depression but not anxiety is associated with metabolic syndrome in primary care based community sample. Psychoneuroendocrinology. 2014; 40: 269-76.
19. Dudek D, Wasik A, Gorostowicz A et al. Otyłość i zaburzenia psychiczne. In: Obesitologia Kliniczna. Olszanecka-Glinianowicz M (ed.). Alfa-medica Press, 2021: 449-76.
20. Fava M. Weight gain and antidepressants. J Clin Psychiatry. 2000; 61(Suppl 11): 37‑41.
21. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010; 71(10): 1259‑72.
22. Dudek D, Cyranka K. Depresja. In: Geriatria. Wybrane zagadnienia. Gąsowski J, Piotrowicz K (eds.). Medycyna Praktyczna, Kraków 2020: 221-36.
23. Fabre LF et al. Trazodone in elderly depressed patients: efficacy and tolerability. J Clin Psychiatry. 1991; 52(9 Suppl): 34‑39.
24. Fabrazzo M et al. Use of trazodone in older adults: a focus on safety and tolerability. Drugs Aging. 2020; 37(3) :163-76.

Most read articles by the same author(s)