Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-11T08:36:53.188Z Has data issue: false hasContentIssue false
  • English
  • Français

Trazodone and exacerbation of psychotic symptoms: an unfamiliar link

Published online by Cambridge University Press:  03 December 2014

M. Osman  and
M. Kilduff
M. Osman*
Affiliation:
Millmount Community Mental Health Services, St Vincent’s Hospital Fairview, Dublin, Ireland
M. Kilduff
Affiliation:
Millmount Community Mental Health Services, St Vincent’s Hospital Fairview, Dublin, Ireland
*
*Address for correspondence: M. Osman, Senior Registrar in General Adult/Academic Psychiatry, Millmount Community Mental Health Services, St Vincent’s Hospital Fairview, Richmond Road, Convent Avenue, Fairview, Dublin 3, Ireland. (Email: mugtabasulman@yahoo.co.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

In this case report we attempt to emphasize the unfamiliar link between trazodone and relapse of psychotic symptoms.

Method

Case report and literature review of relevant papers.

Results

We report a case of a 78-year-old woman with an established diagnosis of paranoid schizophrenia who has experienced an exacerbation of positive psychotic symptoms following initiation of 50 mg dailydose of trazodone. We noted that psychotic symptoms abated following discontinuation of trazodone.

Conclusion

Trazodone use in patients in remission from schizophrenia may be associated with relapse of psychotic symptoms and caution is required.

Keywords

Psychotic disordersrecurrenceschizophreniasleep initiation and maintenance disorderstrazodone
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 4 , December 2015 , pp. 337 - 339
Copyright
© College of Psychiatrists of Ireland 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bertschy, G, Ragama-Pardos, E, Muscionico, M, Aït-Ameur, A, Roth, L, Osiek, C, Ferrero, F (2005). Trazodone addition for insomnia in venlafaxine-treated, depressed inpatients: a semi-naturalistic study. Pharmacological Research 51, 79–84.CrossRefGoogle ScholarPubMed
Bon, OL (2005). Low-dose trazodone effective in insomnia. Pharmacopsychiatry 38, 226.CrossRefGoogle ScholarPubMed
Breier, A (1995). Serotonin, schizophrenia and antipsychotic drug action. Schizophrenia Research 14, 187–202.CrossRefGoogle ScholarPubMed
Electronic Medicines Compendium (2009). Summary of Product Characteristics. http://www.medicines.org.uk/emc/medicine/26734. Accessed 12 September 2013.Google Scholar
Feighner, JP (1999). Mechanism of action of antidepressant medications. Journal of Clinical Psychiatry 60 (Suppl. 4): 4–11.Google ScholarPubMed
Feighner, JP, Boyer, WF (1988). Overview of USA controlled trials of trazodone in clinical depression. Psychopharmacology (Berlin) 95 (Suppl): S50–S53.CrossRefGoogle ScholarPubMed
Fernandez, HH, Trieschmann, ME, Friedman, JH (2003). Treatment of psychosis in Parkinson’s disease: safety considerations. Drug Safety 26, 643–659.CrossRefGoogle ScholarPubMed
Gałecki, P, Florkowski, A, Talarowska, M (2010). Skuteczność trazodonu w leczeniu bezsenności (Efficacy of trazodone in the treatment of insomnia). Polski Merkuriusz Lekarski 28, 509–512.Google ScholarPubMed
Geyer, MA, Vollenweider, FX (2008). Serotonin research: contributions to understanding psychoses. Trends in Pharmacological Sciences 29, 445–453.CrossRefGoogle ScholarPubMed
Graham, JM, Sussman, JD, Ford, KS, Sagar, HJ (1998). Olanzapine in the treatment of hallucinosis in idiopathic Parkinson’s disease: a cautionary note. Journal of Neurology, Neurosurgery, and Psychiatry 65, 774–777.CrossRefGoogle ScholarPubMed
Karam-Hage, M, Brower, KJ (2003). Open pilot study of gabapentin versus trazodone to treat insomnia in alcoholic outpatients. Psychiatry and Clinical Neurosciences 57, 542–544.CrossRefGoogle ScholarPubMed
Kraft, TB (1983). Psychoses following trazodone administration. American Journal of Psychiatry 140, 1383–1384.Google ScholarPubMed
Mendelson, WB (2005). A review of the evidence for the efficacy and safety of trazodone in insomnia. Journal of Clinical Psychiatry 66, 469–476.CrossRefGoogle ScholarPubMed
Mizoguchi, Y, Monji, A (2005). Low-dose-trazodone-induced disorganized type psychosis. Journal of Neuropsychiatry and Clinical Neuroscience 17, 253–254.CrossRefGoogle ScholarPubMed
Patterson, BD, Srisopark, MM (1989). Severe anorexia and possible psychosis or hypomania after trazodone-tryptophan treatment of aggression. Lancet 6, 1017.CrossRefGoogle Scholar
Sheehan, DV, Rozova, A, Gossen, ER, Gibertini, M (2009). The efficacy and tolerability of once-daily controlled-release trazodone for depressed mood, anxiety, insomnia, and suicidality in major depressive disorder. Psychopharmacology Bulletin 42, 5–22.Google ScholarPubMed
Stahl, SM (2009). Mechanism of action of trazodone: a multifunctional drug. CNS Spectrums 14, 536–546.CrossRefGoogle ScholarPubMed
Sultzer, DL, Gray, KF, Gunay, I, Berisford, MA, Mahler, ME (1997). A double-blind comparison of trazodone and haloperidol for treatment of agitation in patients with dementia. American Journal of Geriatric Psychiatry 5, 60–69.CrossRefGoogle ScholarPubMed
Taylor, D, Paton, C, Kapur, S (2012). The Maudsley Prescribing Guidelines, 11th edn. Wiley-Blackwell Publishing: West Sussex. chapter 4, p. 216.Google Scholar
Thase, ME (2003). Evaluating antidepressant therapies: remission as the optimal outcome. The Journal of Clinical Psychiatry 64 (Suppl. 13): 18–25.Google ScholarPubMed
The Joint Formulary Committee (2014). British National Formulary, 67th edn. BMJ Group and Royal Pharmaceutical Society Publishing: London. p. 249.Google Scholar
Wichniak, A, Wierzbicka, A, Sobańska, A, Szatkowska, E, Czasak, K, Musińska, I, Jernajczyk, W (2007). Skuteczność trazodonu w leczeniu bezsennościpierwotnej u pacjentów nieprzyjmujących lekównasennych i przyjmujących je w przeszłości (The effectiveness of treatment with trazodone in patients with primary insomnia without and with prior history of hypnotics use). Polski Merkuriusz Lekarski 23, 41–46.Google Scholar
Zavesicka, L, Brunovsky, M, Horacek, J, Matousek, M, Sos, P, Krajca, V, Höschl, C (2008). Trazodone improves the results of cognitive behaviour therapy of primary insomnia in non-depressed patients. Neuro Endocrinology Letters 29, 895–901.Google ScholarPubMed