Real-World Use of Trazodone in Older Persons in Long Term Care Setting: A Retrospective Study

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-10-31 DOI:10.1002/gps.70009

Alessandra Coin, Alba Malara, Marianna Noale, Caterina Trevisan, Maria Devita, Angela Marie Abbatecola, Pietro Gareri, Stefania Del Signore, Giuseppe Bellelli, Stefano Fumagalli, Fabio Monzani, Enrico Mossello, Stefano Volpato, Gianluca Zia, Raffaele Antonelli Incalzi, the GeroCovid Observational Working Group

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引用次数: 0

Abstract

Background

Trazodone, an antidepressant drug is also largely used in several medical contexts. Insomnia, behavioral disorders, and anxiety may be underlying symptoms for prescribing trazodone. This cross-sectional study aims to identify reasons for trazodone prescription, assess the efficacy, as well as identify any related side effects in older persons living in long term care facilities (LTCFs).

Methods

Older adults aged ≥ 60 years, at risk of or affected with Covid-19 and enrolled in the GeroCovid Observational study from LTCFs, and using trazodone were included. A structured questionnaire was administered to treating physicians regarding reasons for trazodone prescription, discontinuation, possible adverse events and benefits.

Results

Thirty-seven out 74 LTCFs participating in both the GeroCovid and GeroCovid Vax studies completed the questionnaire regarding trazodone use. Of the 427 participants included in this study analysis, we found that 43% had diagnoses of dementia and depression, 33% had dementia, no behavioral and psychological symptoms of dementia (BPSD) and no depression, 14% had dementia with BPSD and no depression, and < 11% had only depression. The main reasons for trazodone prescription included agitation, insomnia, depression and anxiety. Trazodone use was reported as partially or totally effective in more than 90% of participants using the drug. Falls were the most frequent adverse event (30% of participants).

Conclusions

Our data suggest that trazodone behaves as an eclectic antidepressant that, in the clinical practice, may also be used for BPSD and insomnia, especially in older people with dementia.

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长期护理环境中老年人曲唑酮的实际使用情况：回顾性研究

背景：曲唑酮（Trazodone）是一种抗抑郁药物，也被广泛应用于多种医疗领域。失眠、行为障碍和焦虑可能是开曲唑酮处方的潜在症状。本横断面研究旨在确定开曲唑酮处方的原因，评估其疗效，并确定长期护理机构（LTCF）中老年人的相关副作用：方法：研究对象包括年龄≥60岁、有可能或患有Covid-19、参加了GeroCovid观察研究并在长期护理机构中使用曲唑酮的老年人。研究人员向主治医生发放了一份结构化问卷，内容涉及曲唑酮的处方原因、停药情况、可能出现的不良反应和益处：参与 GeroCovid 和 GeroCovid Vax 研究的 74 家 LTCF 中，有 37 家完成了有关曲唑酮使用情况的问卷调查。在纳入本研究分析的 427 名参与者中，我们发现 43% 的人被诊断患有痴呆症和抑郁症，33% 的人患有痴呆症，没有痴呆症的行为和心理症状 (BPSD)，也没有抑郁症，14% 的人患有痴呆症，有 BPSD，也没有抑郁症，< 11% 的人只有抑郁症。开曲唑酮处方的主要原因包括激动、失眠、抑郁和焦虑。据报告，超过 90% 的参试者在使用曲唑酮时部分或完全有效。跌倒是最常见的不良反应（30%的参与者）：我们的数据表明，曲唑酮是一种折衷抗抑郁药，在临床实践中也可用于治疗BPSD和失眠症，尤其是老年痴呆症患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.