Comparative evaluation of trazodone monotherapy and routine anxiolytic therapy in patients with mixed anxiety-depressive disorder
https://doi.org/10.30629/2618-6667-2017-76-52-60
Abstract
The purpose of this study was to examine the efcacy and tolerability of trazodone monotherapy in comparison with routine treatment in patients with mixed anxiety-depressive disorder. Material and methods: the study was performed in the sample of 115 patients: 60 — the main group (trazodone monotherapy), 55 — control group (routine treatment) using the clinical-psychopathological method and psychometric scales (UKU, HAMD-17, Holmes–Ray scale, Shihan social adaptation scale). In the course of the study, the dynamics of psychopathological manifestations, the impact on social adaptation, the adverse effects and their severity in each group were recorded. The duration of the study was eight weeks. Results: trazodone monotherapy showed high efcacy in a mixed anxiety-depressive disorder, comparable to the effect achieved with the administration of several drugs in routine practice. Conclusion: civen the effectiveness, favorable safety profle and economic benefts, trazodone monotherapy is recommended for the treatment of patients with mixed anxiety-depressive disorder.
About the Authors
Alla AvedisovaRussian Federation
PhD, MD, professor, head of therapy of mental & behaviour disorders department
Maxim Marachev
Russian Federation
PhD, MD, candidate of medical sciences, senior researcher
Ksenia Zakharova
Russian Federation
PhD, MD, candidate of medical sciences, senior researcher
Guzel Dashkina
Russian Federation
chief of unit
Fatima Shavlokhova
Russian Federation
PhD, MD, candidate of medical sciences, psychiatrist
Georgiy Kustov
Russian Federation
researcher
Yuliana Less
Russian Federation
PhD, MD, candidate of medical sciences, senior researcher
Marina Terentyeva
Russian Federation
PhD, MD, candidate of medical sciences, senior researcher
Mikhail Zinchuk
Russian Federation
PhD, MD, candidate of medical sciences, leading researcher
Irina Galkina
Russian Federation
chief of unit
Inna Arkusha
Russian Federation
junior researcher
References
1. Mittur A. Trazodone: properties and utility in multiple disorders. Expert Rev. Clin. Pharmacol. 2011;4(2):181–196. doi: 10.1586/ ecp.10.138
2. Lopes R., Alves J.C., Rego R.G. Trazodone addition to paroxetine and mirtazapine in a patient with treatment-resistant depression: The pros and cons of combining three antidepressants. Case reports in medicine. 2016;2016. doi: 10.1155/2016/5362485
3. Fagiolini A., Comandini A., Catena Dell’Osso M., Kasper S. Rediscovering trazodone for the treatment of major depressive disorder. CNS Drugs. 2012;26(12):1033–1049. doi: 10.1007/s40263-013-0088-4
4. Papakostas G.I., Fava M. A meta-analysis of clinical trials comparing the serotonin (5HT)-2 receptor antagonists trazodone and nefazodone with selective serotonin reuptake inhibitors for the treatment of major depressive disorder. European Psychiatry. 2007;22(7):444–447. doi:10.1016/j.eurpsy.2007.01.1220
5. Avedisova A.S., Goncharov V.N. Prolongirovannyj antidepressant trittiko pri terapii nevroticheskoj depressii. Zhurnal social'noj i klinicheskoj psihiatrii. 1993;3:107–113. (In Russ.).
6. Gelenberg A.J., Freeman M.P., Markowitz J.C., Rosenbaum J.F., Thase M.E., Trivedi M.H., Rhoads R.S., Reus V.I., DePaulo J.R., Schneck C.D., Silbersweig D.A. Practice guideline for the treatment of patients with major depressive disorder. Third edition. The American Journal of Psychiatry. 2010;167(10):1-118. doi: 10.1176/appi.books.9780890423387.654001
7. Kim W., Jung H., Choi H., Park C., Kim E., Lee S., Ko S., Kim S., Joa K. The associations between insomnia and health-related quality of life in rehabilitation units at 1 month after stroke. Journal of Psychosomatic Research. 2017;96:10–14. doi: 10.1016/j. jpsychores.2017.02.008
8. Osváth P. Current treatment of depression and agitation in the elderly-clinical use of trazodone. Neuropsychopharmacologia Hungarica: a Magyar Pszichofarmakologiai Egyesulet lapja official journal of the Hungarian Association of Psychopharmacology. 2013;15(3):147-155. PMID: 24108179
9. Poltorak S.V., Mihajlov V.A., Poljakov A.Ju. Trazodon v kompleksnoj terapii trevozhno-depressivnyh rasstrojstv. Obozrenie psihiatrii i medicinskoj psihologii im. V.M. Behtereva. 2012;2:74. (In Russ.).
10. Bossini L., Casolaro I., Koukouna D., Cecchini F., Fagiolini A. Off-label uses of trazodone: a review. Expert Opinion on Pharmacotherapy. 2012;13(12):1707–1717. doi: 10.1517/14656566.2012.699523
11. Bossini L., Coluccia A., Casolaro I., Benbow J., Amodeo G., De Giorgi R., Fagiolini A. Off-Label trazodone prescription: evidence, benefits and risks. Current Pharmaceutical Design. 2015;21(23):3343–3351. doi:10.2174/1381612821666150619092236
12. Khouzam H. A review of trazodone use in psychiatric and medical conditions. Postgraduate Medicine. 2016;129(1):140–148. doi:10.10 80/00325481.2017.1249265
13. Stahl S.M. Mechanism of action of trazodone: a multifunctional drug. CNS spectrums. 2009;14(10):536–546. doi:10.1017/ s1092852900024020
14. Wichniak A., Wierzbicka A. The effects of antidepressants on sleep in depressed patients with particular reference to trazodone in comparison to agomelatine, amitriptyline, doxepin, mianserine and mirtazapine. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 2011;31(181):65–70. PMID:21870714.
Review
For citations:
Avedisova A., Marachev M., Zakharova K., Dashkina G., Shavlokhova F., Kustov G., Less Yu., Terentyeva M., Zinchuk M., Galkina I., Arkusha I. Comparative evaluation of trazodone monotherapy and routine anxiolytic therapy in patients with mixed anxiety-depressive disorder. Psychiatry (Moscow) (Psikhiatriya). 2017;(76):52-60. (In Russ.) https://doi.org/10.30629/2618-6667-2017-76-52-60