The use of trazodone as a hypnotic: a critical review.

@article{James2004TheUO,
  title={The use of trazodone as a hypnotic: a critical review.},
  author={Steven P. James and Wallace B. Mendelson},
  journal={The Journal of clinical psychiatry},
  year={2004},
  volume={65 6},
  pages={
          752-5
        }
}
BACKGROUND The last few years have seen a remarkable rise in the off-label use of trazodone for inducing sleep in nondepressed patients, to a degree that it is prescribed for this purpose as commonly as the leading hypnotic. In view of this widespread popularity, it seems prudent to review what is known of the safety and efficacy of trazodone when used in this context. DATA SOURCES AND SELECTION A MEDLINE search of the literature published in English between 1975 and 2003 that included the… 
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References

SHOWING 1-10 OF 32 REFERENCES
Trazodone. A review of its pharmacology, therapeutic use in depression and therapeutic potential in other disorders.
TLDR
Results from a small number of short term comparative studies in a total of 320 evaluable elderly patients with major depression suggest that trazodone at therapeutic doses is superior to placebo and as effective as amitriptyline, imipramine, fluoxetine and mianserin in relieving depressive symptoms.
The role of trazodone in the treatment of depressed cardiac patients.
TLDR
It is possible that the so-called 'trazodone aggravation' of ventricular irritability is a statistical artifact--although further research is needed to verify this conclusion, and in the meantime the drug should be used with caution in such patients.
Acute behavioral effects and abuse potential of trazodone, zolpidem and triazolam in humans
TLDR
Examination of the acute behavioral effects and abuse potential of three drugs commonly used to treat sleep disorders, trazodone, zolpidem and triazolam, and placebo in ten male volunteers with histories of alcohol and drug abuse suggests that traZodone has less abuse potential than triazolate, and may be a viable alternative to benzodiazepine hypnotics in individuals with historiesof alcohol or drug abuse.
Survey on the usefulness of trazodone in patients with PTSD with insomnia or nightmares.
TLDR
Trazodone appears effective for the treatment of insomnia and nightmares associated with chronic PTSD, however, controlled trials are needed before any definite conclusions can be drawn.
Effects of trazodone and fluoxetine in the treatment of major depression: therapeutic pharmacokinetic and pharmacodynamic interactions through formation of meta-chlorophenylpiperazine.
TLDR
It is suggested that desensitization of 5-HT2C receptor function by mCPP as well as fluoxetine may contribute to the antidepressant effects of this combination of fluoxettine + trazodone.
Trazodone and valproate in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal symptoms and taper outcome
TLDR
A double-blind study to assess whether trazodone and valproate would attenuate withdrawal and facilitate discontinuation in BZ-dependent patients with a minimum of 1 year daily BZ use, finding that both agents had no significant effect on withdrawal severity.
Oral trazodone is not effective therapy for erectile dysfunction: a double-blind, placebo controlled trial.
TLDR
Trazodone is no more effective than placebo in improving erections and sexual function in patients with severe physiological erectile dysfunction.
Subjective hypnotic efficacy of trazodone and zolpidem in DSMIII–R primary insomnia
TLDR
Both trazodone and zolpidem improved self‐reported sleep latency and duration of non‐depressed, primary insomniacs; zolPidem was somewhat more efficacious at the doses studied.
Mirtazapine is more effective than trazodone: a double‐blind controlled study in hospitalized patients with major depression
TLDR
In this trial, mirtazapine showed significant clinical advantages over trazodone in terms of overall efficacy and tolerability and postural symptoms were a clinical problem in >' 6% of the traZodone-treated patients.
Trazodone and triazolam: acute subject-rated and performance-impairing effects in healthy volunteers
TLDR
Trazodone may be a viable alternative to benzodiazepine hypnotics like triazolam, especially when needing to minimize drug-induced impairment, and should be considered in a clinically relevant population such as individuals with histories of drug abuse.
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