Loading...
Please wait, while we are loading the content...
Similar Documents
Discussion and concluding remarks
| Content Provider | Semantic Scholar |
|---|---|
| Author | Perkins, Elizabeth Gambles, Maureen Houten, Rachel Harper, Sheila Haycox, Alan Obrien, T. Richards, Sarah Chen Nolan, Kate Ellershaw, John E. |
| Copyright Year | 2004 |
| Abstract | Feighner: In most of the studies the dosage range was 100-400. In the inpatients we can go up to 400 and I believe in some of the outpatients it was 300, but also up to 400. In general, also, the ratio of the dosage between trazodone and the comparator tricyclic was usually 2 to 1, that is, that the studies were Fixed fluxable. We had a minimum amount that the patients could take and still remain in the study and then you had the maximum amount which the investigator could then increase depending on clinical response, side effects, the overall therapeutic response, and we estimated that there would be about a 2 to 1 ratio. It turned out it was not 2 to 1, it averaged probably more like about 3 to 2. It looks like 300 of trazodone would be roughly equivalent to 175-200 of amitriptyline, for example. So that's how the dosages were set up. In clinical practice we Find some patients who do very well, particularly geriatric patients, on as little as 25-50 rag, at bedtime, and we find other patients that we go all the way up to 40(000 and on rare occasions 800 rag. That's not common, but there are people who do well on that. Until recent years, I was interested in the sleep study that was presented. We had patients with insomnias that nothing would touch except trazodone and I had about 10-15 of them that I followed for a number of years and trazodone probably did better. I don't know what their precise diagnosis was, but they couldn't sleep and were depressed. Trazodone seemed to work very effectively. Some of the patients required 800 mg to sleep at night and this dose seemed not to interfere with their blood pressure or to produce other side effects. Then to reply to the second question. We have combined the drug with MAO inhibitors and we have done so successfully in a number of patients. We have to be careful about its alpha-adrenolytic effect. However, rarely have we had anything that even looks like hypertension unless someone goes off their low tyramine diet. More commonly, what happens is that they will get a lowering of blood pressure and we have to really caution them about it earlier o n . Usually I like to have them on trazodone and whatever dose they seem to tolerate ffLrst and then carefully add the MAO inhibitor. If they're in the hospital, 1 would certainly go on and institute, not both of them together, but first a MAO inhibitor and then start with trazodone successfully. They can be used together but the biggest problem is orthostatic or low hypotension or a lowering of blood pressure. |
| Starting Page | S54 |
| Ending Page | S56 |
| Page Count | 3 |
| File Format | PDF HTM / HTML |
| DOI | 10.1007/BF00172632 |
| Alternate Webpage(s) | http://www.rug.nl/research/portal/files/14536500/c6.pdf |
| Alternate Webpage(s) | https://doi.org/10.1007/BF00172632 |
| Volume Number | 95 |
| Journal | Psychopharmacology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Discussion |
