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Medline ® Abstract for Reference 65

of 'Pediatric palliative care'

Does trazodone have a role in palliating symptoms?
Davis MP
Support Care Cancer. 2007;15(2):221. Epub 2006 Nov 28.
INTRODUCTION: Trazodone is a unique antidepressant, which blocks the postsynaptic serotonin (5-HT) receptors, 5-HT(2A) and 5-HT(2C), and weakly inhibits presynaptic 5-HT transporters.
DISCUSSION: Trazodone is well-absorbed by the mouth and is metabolized by three cytochromes: CYP1A2, CYP2D6, and CYP3A4. Clinical benefits include reduced insomnia in those depressed and/or on antidepressants. Pain may be relieved by mechanisms similar to venlafaxine. Delirium unresponsive to neuroleptics has been reported to respond to trazodone. Drug interactions are a risk due to cytochrome metabolism.
CONCLUSION: Trazodone has a unique pharmacology, which may be an advantage in palliating symptoms; however, little evidence is available through cohort or randomized trials to give guidance to its use.
The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic Foundation, M76, Cleveland, OH 44195, USA. davism@ccf.org