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Trazodone is a serotonin antagonist/reuptake inhibitor, approved for treating major depressive disorder (MDD). Oral formulations are widely studied and marketed in several countries worldwide while there is little evidence to support use of parenteral formulation. Our narrative review summarizes pharmacological properties and clinical data concerning use of parenteral trazodone in mood disorders. PubMed and Web of Science were used to identify the most relevant literature. The main evidence concerns four studies evaluating efficacy in major depressive disorder and indicates that trazodone was well tolerated and effective. Off-label use in agitation associated with bipolar disorder is also reported in three studies, although prescription of concomitant treatment, as a confounding factor, may have influenced outcome measures. The limited available evidence supports parenteral trazodone use in major depressive disorder and suggests that trazodone is a suitable option in patients at high risk of treatment-emergent mania (TEM). [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? Following years of initiatives to reduce potentially inappropriate antipsychotic use in nursing homes, are there differences in the initiation of trazodone among newly admitted residents over time? • What is the main finding of this study? Relative to those admitted in 2014 (a period associated with and leading up to several antipsychotic reduction efforts in Ontario, Canada), residents admitted prior (2010–2013) were more likely to be initiated on an antipsychotic, while residents admitted after (2015–2018) were less likely to be initiated on an antipsychotic. Residents with dementia showed greater changes in medication initiation by year of admission, such that those admitted in the later period were more likely to be initiated on trazodone and less likely to be initiated on an antipsychotic compared to residents with dementia admitted in 2014. • What is the meaning of the finding? Following efforts to reduce potentially inappropriate antipsychotic use in nursing homes, this study suggests a potential change to prescribing behavior over time, with trazodone possibly being initiated in lieu of antipsychotics for dementia symptoms. To investigate whether trazodone is being initiated in lieu of antipsychotics following antipsychotic reduction efforts, this study described changes in medication initiation over time. We conducted a retrospective cohort study of new admissions to nursing homes in Ontario, Canada between April 2010 and December 2019 using health administrative data (N = 61,068). The initiation of antipsychotic and trazodone use was compared by year of admission using discrete time survival analysis and stratified by history of dementia. Relative to residents admitted in 2014, antipsychotic initiation significantly decreased in later years (e.g., 2017 admission year hazard odds ratio [HOR 2017 ]=0.72 [95% confidence interval (95%CI)=0.62–0.82]) while trazodone initiation modestly increased (e.g., HOR 2017 =1.09 [95%CI=0.98–1.21]). The relative increase in trazodone initiation was larger among residents with dementia (e.g., HOR 2017Dem =1.22 [95%CI=1.07–1.39]). Differences in which medications were started following nursing home admission were observed and suggest trazodone may be initiated in lieu of antipsychotics. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: To comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants in a large dataset from the GeroCovid Observational multiscope and multisetting study. Findings: 10.8% out of 3396 persons included used trazodone and the 8.5% other antidepressants; the use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to long-term care facilities or living at home. Conditions associated with trazodone use included depression, dementia and behavioral and psychological symptoms of dementia. Message: The present data suggest an off-label use of trazodone as a possible therapeutic option in the challenging field of behavioral and psychological disturbances in older adults with dementia. Background and objectives: Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. Methods: This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Results: Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. Discussion: The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD. [ABSTRACT FROM AUTHOR]

Sedative antidepressants are commonly used drugs in the treatment of insomnia. However, some recommendations claim that only hypnotics have been proven effective in the treatment of sleep initiation and maintenance disorders. The aim of this article is to compare the effect of hypnotics and trazodone on sleep, and to analyse the evidence for the use of trazodone in the treatment of insomnia. Three studies investigated the effects of trazodone on sleep in primary insomnia, 5 studies on insomnia in the course of affective disorders and 6 studies on insomnia in other indications (PTSD, Alzheimer's disease, alcohol and opiate dependence, somatoform disorder, and insomnia during pregnancy). In the treatment of insomnia, trazodone is less effective than hypnotics in the treatment of sleep onset insomnia (i.e., disorders of falling asleep). For this indication it needs to be administered earlier than hypnotics, at least 1 hour before bedtime. It is, however, very effective in the treatment of sleep-maintenance insomnia, especially in patients with comorbid mental disorders or patients treated with activating antidepressants. Hypnotics and trazodone have the opposite effect on deep sleep. Trazodone increases the duration of deep sleep, which is associated with better sleep quality as assessed by patients. In contrast, hypnotics decrease slow-wave activity in sleep EEG, which is the biomarker of deep sleep. The main mechanism through which trazodone promotes sleep is its antagonistic effect on 5-HT2 serotonin receptors, while hypnotics are agonists of gamma-aminobutyric acid GABAA receptors, and other sedative antidepressants block H1 histamine receptors. This is associated with a low risk of weight gain, which is rare with trazodone treatment. [ABSTRACT FROM AUTHOR]

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Copyright of Turkish Journal of Psychiatry is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Companion dogs housed in animal shelters are subject to a great number of uncontrollable and unalterable stressors. To combat these stressors and the associated immunosuppression that can result in high rates of contagious disease in sheltered dogs, a large open admission municipal animal shelter in New York City introduced trazodone hydrochloride, a serotonin receptor antagonist and reuptake inhibitor, to help reduce their transitional stress. Dogs were given low doses of trazodone at intake (5 mg/kg), one to two doses within 48 hours of arrival. Prevalence of illness was calculated for two time periods at the Brooklyn and Manhattan Care Center locations (N = 1,766): November and December 2018, when trazodone was administered to the population, and a historical control in November and December 2017 and 2016, when no trazodone was administered. A statistically significant difference in the percentage of sick dogs was found when comparing the No Trazodone group (2016/2017) and Trazodone treatment group in 2018 (Chi2 [1, N = 1766] = 19.4, P < 0.001). An increased percentage of sick dogs was observed in the No Trazodone group (41%) compared with the Trazodone treatment group (29%). Moreover, a significant difference in the average length of stay (LOS) in the shelter was observed when comparing the two groups (t (1764) = 2.71, P = 0.007). The average LOS was longer for the dogs in the No Trazodone group (M = 10.47, standard deviation SD = 8.53) than that for those in the Trazodone treatment group (M = 9.23, SD = 6.57). Finally, a significant difference was observed in the percent of adoptions between the two groups (Chi2 [1, N = 1766] = 19.4, P < 0.001). A larger percentage of dogs were adopted in the Trazodone treatment group (42%) than in the No Trazodone group (30%). While correlational, the preliminary results of this study suggest that trazodone may be effective in reducing illness and increasing adoptions by decreasing transitional stress in dogs living in a shelter setting. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim We examined the first- and second-line pharmacological treatment for delirium to determine which drugs were chosen, how and when second-line drugs were started, and the effectiveness and tolerability of those treatments. Methods A retrospective medical chart review was performed for delirium inpatients referred to the Department of Psychiatry, Hiroshima Citizens Hospital, from October 2011 to September 2012. Clinical diagnoses were based on ICD-10. We compared the baseline severity of delirium, duration needed for improvement, and rescue with antipsychotics between subjects given only first-line drugs and those switched to second-line drugs. Results We studied 194 consecutive patients including 127 men and 67 women whose average age was 76.5 ± 9.8 years. For first-line drugs, trazodone was most frequently prescribed (n = 100, 51.5%), followed by quetiapine (n = 57, 29.4%). Among patients treated with trazodone or quetiapine as first line treatment, 59 of 100 (59%) continued trazodone and 52 of 57 (91.2%) continued quetiapine. Duration needed for improvement did not differ significantly between patients treated with trazodone as a first line drug and those with quetiapine as same. Conclusion Trazodone can be a candidate drug as one of the first line drugs for delirium. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: While trazodone is approved for the treatment of depression, the off-label use of this medication for insomnia has surpassed its usage as an antidepressant. In this systematic review, we examined the evidence for the efficacy and safety of trazodone for insomnia. METHODS: A literature search was conducted using MEDLINE/PubMed databases from the past 33 years (1983-2016) and the keywords insomnia, trazodone, sedative, treatment, and hypnotics. The results were restricted to English language and human subjects. All randomized clinical trials, meta-analyses, observational studies, and placebo-controlled trials regarding trazodone for the treatment of primary or secondary insomnia were reported, per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study selection process yielded a total of 45 studies. RESULTS: Evidence for the efficacy of trazodone has been repeatedly demonstrated for primary insomnia, as well as secondary insomnia, including for symptoms that are a result of depression, dementia, and being a healthy man. Earlier studies (1980-2000) focused on utilizing trazodone at high doses (≥100mg/d) for the treatment of insomnia among the depressed population; however, since the 2000s, the utility of trazodone has been expanded to treat secondary insomnia among the non-depressed population as well. The side effects are dose-dependent, and the most common is drowsiness. CONCLUSION: A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia. [ABSTRACT FROM AUTHOR]

Trazodone is an antidepressant that is FDA-approved for the treatment of depression. It has been used by mental health and primary care providers for the treatment of multiple psychiatric and medical conditions .This review describes trazodone mechanism of action, formulation, dosage and adverse effects and then summarizes the beneficial effects of trazodone in the treatment of various psychiatric and medical conditions such as major depression, as well non-approved FDA indications such as insomnia,anxiety disorders, posttraumatic stress disorder, obsessive compulsive disorder, feeding and eating disorders, substance use disorders, behavioral disturbances associated with cognitive dysfunction, sexual dysfunction, certain pain conditions, and rehabilitation after acute ischemic stroke. Despite trazodone’s favorable effects in the treatment of FDA-unapproved psychiatric and medical conditions, large, randomized controlled clinical trials are still needed to confirm its efficacy in the treatment of the multiple conditions for which it is often used in clinical practice. [ABSTRACT FROM PUBLISHER]

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The article reports on research which was conducted to investigate the efficacy of using the drug trazodone to treat sleep disturbances in patients with Alzheimer's disease. Researchers evaluated 30 patients, 15 of whom received trazodone. They found that trazodone helped patients sleep longer and concluded that it offered significant therapeutic effects to patients.

In this study, the adsorption of a multicomponent mixture of active pharmaceutical compounds, such as Venlafaxine (VLX), Trazodone (TRZ) and Fluoxetine (FLX), was studied in a biochar fixed-bed column. The selection of appropriate biochar (eucalyptus, grapevine cane and holm tree biochar) as an adsorbent was carried out through batch assays. An insight into the adsorption mechanism and its correlation with the chosen biochars was performed, showing that electron donor/acceptor interaction is the main mechanism involved. Equilibrium and kinetic batch adsorption experiments were performed and the results demonstrated that eucalyptus biochar was the most viable option for the removal of the pollutants, individually and combined. Column adsorption experiments were performed and Thomas, Yoon-Nelson and Yan models were adjusted to the breakthrough curves. This multicomponent system exhibited a synergetic behavior for TRZ and an antagonist for VLX and FLX, when compared to the single and multicomponent systems previously evaluated in batch assays. The treatment of real wastewaters, spiked with pollutants, has demonstrated the removal efficiency of multicomponent mixtures. Finally, the adsorbent regeneration by elution in different solutions was also investigated and methanol proved to be the most effective eluent for the column regeneration. [Display omitted] • Efficient individual removal of pharmaceuticals by Eucalyptus biochar was proved. • An extensive adsorption mechanism analysis was performed. • Feasible continuous treatment system for removal of a mixture of pharmaceuticals. • Successful removal of pharmaceutical mixture both in synthetic and real wastewater. [ABSTRACT FROM AUTHOR]

Abstract: Background: Erectile dysfunction (ED) has been a prevalent disease worldwide. The mainstay of treatment for ED focused on oral medications such as phosphodiesterase-5 (PDE-5) inhibitors or other medical aids with variable acceptance. Trazodone is a second-generation antidepressant approved by the U.S. Food and Drug Administration in 1981. Some evidence has suggested that trazodone may be helpful in improving ED, especially for problems dealing with male arousal. Although controversial, trazodone can sometimes be used for ED as an off-label medication for urological patients. By using a nationwide health insurance database, we attempted to estimate and thereafter analyze the existence and extent of off-label use of trazodone for ED in Taiwan. Methods: The 1/500 randomly sampled outpatient visits dataset and the 1/1 million randomly selected dataset issued in 2000 in the National Health Insurance Research Database were used to estimate the total number of visits and the urological visits involving trazodone prescriptions. The refill rate, patient age at first prescription, and the diagnoses assigned to the prescription visits were also gathered and analyzed. Results: The prescription visits in urological clinics consisted exclusively of male patients (99.0 ± 1.3%, p < 0.001). The use of trazodone was more prevalent and regular among the elderly (p < 0.001), which happens to parallel the trend of incidence rates of ED. Starting in 1998, the prescription rate for trazodone increased rapidly, but then slowed, equalized, and topped out in 2003. One of the reasons for this marked change in prescriptions rates in Taiwan may be the increased awareness of ED as a treatable disease under the promotion and marketing of three PDE-5 inhibitors. ED-related diagnoses assigned to the prescription visits accounted for 55% of total visits, whereas anxiety/depression-associated diagnoses were the bases of less than 13%, and those attributed to insomnia accounted for 2.3% of visits. Conclusion: Despite the fact that trazodone was not officially approved for patients with urological conditions, this medication has been used as an ED treatment in Taiwan at least since 1997; the prescriptions of trazodone were more prevalent among the elderly, and this trend increased, then evened out, and eventually reached its maximum point in 2003, correlating with the introduction of PDE-5 inhibitors. [Copyright &y& Elsevier]

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The article reports on research conducted to describe and evaluate a new protocol using nonopioid medications (clonidine, lorazepam, trazodone, and a stimulant) which was used to complete outpatient opioid detoxification and to determine clinical and demographic characteristics of patients who successfully completed outpatient opioid detoxification. Researchers found that the protocol led to excellent rates of detoxification.

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Abstract: Background: Older adults are susceptible to a variety of illnesses, many of which can be treated with medications that may need to be used for the long term. Considerable attention has been paid to drugs that, in addition to their intended function, may have an anticholinergic effect that results in undesirable side effects, including impairment in cognition. Cholinesterase inhibitors are used as procholinergic drugs to improve cognitive dysfunction in Alzheimer''s disease. We hypothesized that some of the drugs commonly used by older adults might, in addition to their intended function, also have procholinergic effects by virtue of inhibiting cholinesterases. Objective: To determine the potential procholinergic nature of some of the commonly used drugs by examining their cholinesterase inhibiting properties. Methods: The Ellman spectrophotometric method was used with human acetylcholinesterase and butyrylcholinesterase, in the absence and presence of increasing concentrations of each test drug. To compare inhibition potencies, from enzyme kinetic data, we determined half maximal inhibitory concentration (IC50 values) for each cholinesterase by each drug. Results: Of the 28 drugs examined, over half (17/28) inhibited one or both of the human cholinesterases. The inhibition potencies were often within 1 to 2 orders of magnitude of reversible cholinesterase inhibitors currently used to treat Alzheimer''s disease. These included trazodone, quetiapine, risperidone, indapamide, and perindopril. Conclusions: Many drugs used by older adults for other reasons have potentially clinically relevant procholinergic effects. The effect of cumulative cholinesterase inhibition merits clinical evaluation. [Copyright &y& Elsevier]

Objective: To investigate the efficacy, safety, and clinical benefit of a once-daily formulation of trazodone (Trazodone Contramid® OAD) in the treatment of major depressive disorder. Design/Participants: In this double-blind study, 412 patients with major depressive disorder (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were randomized 1:1 to receive either Trazodone Contramid OAD (150 to 375mg) or placebo. Treatment was titrated over two weeks to each individual optimal dose. Patients then continued six weeks of treatment; further dose adjustments were allowed based on efficacy and tolerability. Measurements: The primary end point was change in the 17-item Hamilton Depression Rating Scale total score from baseline to last study visit. Secondary end points included Hamilton Depression Rating Scale responders/remitters, change in Montgomery-Åsberg Depression Rating Scale, Clinician and Patient Global Improvement Scales, and quality of sleep. Results: From the end of titration to the end of the six-week treatment period, the mean maximum daily dose of the intent-to-treat population was 310mg for the active group and 355mg for the placebo group. There was a statistically significant difference between trazodone and placebo on the mean HAMD-17 score (-11.4 vs. -9.3, P=0.012). A significant difference was present as early as Week 1 and was maintained at all subsequent study visits. Many secondary end points supported these findings, including improvements in quality of sleep. The most frequent adverse events were the same for both the treatment and placebo groups: headache and somnolence. There were no serious adverse events that were considered related to treatment. There were no clinically significant electrocardiogram or laboratory abnormalities. Conclusions: The trazodone Contramid formulation was more effective than placebo in major depressive disorder and was well tolerated. [ABSTRACT FROM AUTHOR]

The article presents a large data-base study which compares the use of quetiapine and trazodone in reducing the time to rehospitalization for patients with alcohol dependence. It was found that there is no difference between the two medications in decreasing the time to rehospitalization when used with other medications and that the risk increases when they are used alone. It stresses the need for more data on the safety and effectiveness of the drugs.

A 29-year-old man presented to the emergency department with chest pain after ingestion of 25 tablets of 50 mg trazodone. Initial electrocardiography revealed a 3-mm ST-segment elevation in leads II, III, and aVF along with reciprocal ST-segment depression in anterior wall leads. Cardiac catheterization showed normal epicardial coronary arteries. His subsequent electrocardiograms showed resolution of ST-segment changes with uneventful recovery. [ABSTRACT FROM AUTHOR]

Sleep problems are common among people who have developmental disabilities and may be responsible for daytime challenging behaviors. This case study evaluated the effects of medication (trazodone) given at bedtime on aggression, self-injury, sleep attempts, and physical restraint encountered during the day with a man who had intellectual disabilities, comorbid psychiatric diagnoses, and a history of erratic sleep. The medication regimen was associated with a clinically significant reduction in challenging behaviors and elimination of physical restraint. The therapeutic implications of these results are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Symptomatic bradycardia following a single low dose of oral trazodone is rare. Herein, we report the case of a patient with major depressive disorder who developed and was able to resolve symptomatic bradycardia following administration of a single low dose of trazodone 50mg, and then discontinuation. This is the first case report of symptomatic bradycardia which might be attributed to a single lowest dose of trazodone in the world. [Copyright &y& Elsevier]

The efficacy of each antidepressant available has been found equal to that of amitriptyline in double-blind studies. However, a few of them are being prescribed (at under-therapeutic doses) for sleep, in non-depressed persons, when there are relative contraindications for sedative-hypnotics. Following previous studies regarding the antinociceptive mechanisms of various antidepressants, we suggest that the involvement of the opioid system in some of the antidepressants' mechanism of action may contribute to these medications' use for the induction and maintenance of sleep. The mostly prescribed antidepressants for sleep are trazodone (a weak, but specific inhibitor of the synaptosomal uptake of serotonin, that also binds to alpha-1 and alpha-2 adrenoreceptor sites) and mirtazapine (a postsynaptic drug which enhances noradrenergic and 5-HT1A-mediated serotonergic neurotransmission via antagonism of central alpha-2-auto- and hetero-adrenoreceptors). In our previous studies when ICR mice were tested with a hotplate analgesia meter, both trazodone and mirtazapine induced, a naloxone-reversible antinociceptive effect following i.p administration. Summing up the various interactions of trazodone and mirtazapine with opioid, noradrenergic and serotonergic agonists and antagonists, we found that the antinociceptive effect of trazodone is influenced by the opioid receptor subtypes mu and delta (and a clear 5-HT mechanism of antinociception), while the antinociceptive effect of mirtazapine is mainly influenced by kappa and mu opioid receptor subtype (combined with both serotonergic and noradrenergic receptors). This opioid profile of the two drugs may be one of the explanations to their efficacy in the treatment of insomnia, when sedatives (either benzodiazepines or the non-benzodiazepine "Z-compounds") cannot be prescribed. [ABSTRACT FROM AUTHOR]

Background: Patient online drug reviews are a resource for other patients seeking information about the practical benefits and drawbacks of drug therapies. Patient reviews may also serve as a source of postmarketing safety data that are more user-friendly than regulatory databases. However, the reliability of online reviews has been questioned, because they do not undergo professional review and lack means of verification.Objective: We evaluated online reviews of hypnotic medications, because they are commonly used and their therapeutic efficacy is particularly amenable to patient self-evaluation. Our primary objective was to compare the types and frequencies of adverse events reported to the Food and Drug Administration Adverse Event Reporting System (FAERS) with analogous information in patient reviews on the consumer health website Drugs.com. The secondary objectives were to describe patient reports of efficacy and adverse events and assess the influence of medication cost, effectiveness, and adverse events on user ratings of hypnotic medications.Methods: Patient ratings and narratives were retrieved from 1407 reviews on Drugs.com between February 2007 and March 2018 for eszopiclone, ramelteon, suvorexant, zaleplon, and zolpidem. Reviews were coded to preferred terms in the Medical Dictionary for Regulatory Activities. These reviews were compared to 5916 cases in the FAERS database from January 2015 to September 2017.Results: Similar adverse events were reported to both Drugs.com and FAERS. Both resources identified a lack of efficacy as a common complaint for all five drugs. Both resources revealed that amnesia commonly occurs with eszopiclone, zaleplon, and zolpidem, while nightmares commonly occur with suvorexant. Compared to FAERS, online reviews of zolpidem reported a much higher frequency of amnesia and partial sleep activities. User ratings were highest for zolpidem and lowest for suvorexant. Statistical analyses showed that patient ratings are influenced by considerations of efficacy and adverse events, while drug cost is unimportant.Conclusions: For hypnotic medications, online patient reviews and FAERS emphasized similar adverse events. Online reviewers rated drugs based on perception of efficacy and adverse events. We conclude that online patient reviews of hypnotics are a valid source that can supplement traditional adverse event reporting systems. [ABSTRACT FROM AUTHOR]

The article presents a study conducted in Great Britain in 2000-2012, which showed that patients who were prescribed antidepressants like mirtazapine and venlafaxine are more likely to commit suicide. Data used in the study were obtained from the Egton Medical Information Systems (EMIS) medical records system. Also cited is the recommendation by the National Institute for Health and Clinical Excellence (NICE) of selective serotonin re-uptake inhibitors (SSRI) as treatment for depression.