P.744 Early response to trazodone in depression: clinical overview

Early response to trazodone once-a-day in major depressive disorder: review of the clinical data and putative mechanism for faster onset of action

“…(Figure 1B and Supplementary Figure S2B). 44,46 This early antidepressant efficacy observed with trazodone OAD is consistent with the evidence from studies of other trazodone formulations for the treatment of MDD. Results from doubleblind, randomized clinical trials of trazodone IR and PR formulations demonstrating its faster onset of antidepressant action are summarized in Table 1.…”

“…Trazodone OAD treatment resulted in statistically significant reduction in the total HAM-D score within 7 days of starting treatment compared to placebo or an active comparator (venlafaxine XR). [44][45][46] At the study endpoint (Day 56), this improvement in depressive symptoms was sustained in the placebo-controlled study with the trazodone OAD treatment. However, in the active-comparator study at Day 56, venlafaxine XR showed greater antidepressant efficacy compared to trazodone OAD in the ITT population and no significant difference was observed in the PP population (the study population with a higher-level treatment compliance); in fact, the severity of depression in both trazodone OAD as well venlafaxine XR groups decreased from moderate to mild in the both the ITT and PP population.…”

“…This significantly higher improvement in the depressive symptoms was sustained in the patients treated with trazodone OAD until the study endpoint (Day 56) compared to patients receiving placebo (Figure 1A and Supplementary Figure S2A). 45,46 Similarly, Fagiolini et al 44 showed that trazodone OAD (dose during the first week: 150 mg/day) showed faster onset of antidepressant action compared to an SNRI, venlafaxine XR (dose during the first week: 75 mg/day) in 324 patients with MDD. A significantly greater reduction in the mean HAM-D17 total score was observed in the trazodone OAD group compared to venlafaxine XR within 7 days of treatment (ITT population: trazodone OAD À4.3 points vs venlafaxine XR À3.5 points [95% CI, À1.5; À0.2]; PP population: trazodone OAD À4.4 points vs venlafaxine XR À3.5 points [95% CI, À1.6; À0.2]; P < .05).…”

“…Results from doubleblind, randomized clinical trials of trazodone IR and PR formulations demonstrating its faster onset of antidepressant action are summarized in Table 1. 27,30,46,47 Efficacy of the trazodone OAD formulation for improvement in the HAM-D17 factors Depression is a multifaceted disorder, which is characterized by depressed mood along with several significant psychological, cognitive, and behavioral components. Different antidepressants, based on their pharmacological profile, may initiate improvement in various clinical components at different rates.…”