Priapism Following Trazodone Overdose with Cocaine Use

Priapism is a urologic disorder and medical emergency with a variety of known etiologies including the use of psychotropic medications. The antidepressant trazodone is the agent most frequently implicated in the precipitation of priapism. Additionally, a number of drugs of abuse including marijuana, ethanol, and cocaine have been known to cause the disorder. It is unknown if drugs may act in an additive or a synergistic manner to cause priapism. We report a case of priapism which occurred following trazodone overdose in an individual actively using cocaine. This case suggests that combined trazodone and cocaine use may pose an additional risk of priapism. Since trazodone is commonly employed as a hypnotic and often chosen for polysubstance abusers due to its low abuse potential, clinicians should be aware of the possible additive risk of priapism in this patient population.     

曲唑酮对脑卒中后抑郁症患者认知功能的影响

目的探讨曲唑酮对脑卒中后抑郁症患者认知功能的影响.方法将脑卒中后抑郁症患者52例随机分为曲唑酮治疗组(n=28)和对照组(n=24),治疗前、治疗后4周及6周分别子HAMD评分和MMSE评分.结果治疗4周及6周后,治疗组抑郁症状改善者明显高于对照组(P＜0.05),且在曲唑酮治疗组,患者的MMSE评分较对照组显著提高(P＜0.05).结论曲唑酮可通过改善脑卒中后抑郁症患者的抑郁状态有效提高其认知功能.     

HPLC法测定人血浆中曲唑酮的浓度

目的 :建立测定人血浆中曲唑酮 (TZD)浓度的RP HPLC法。方法 :以美国Dikma公司DiamonsilTMC18反相柱 (2 5 0mm×4 6mm ,5 μm)为色谱柱 ,流动相为甲醇 超纯水 (85∶15 ,V/V) ,流速为 0 8mL·min-1,检测波长 2 5 6nm ,以乙酸乙酯为提取剂。结果 :TZD高 (83 33mg·L-1)、中 (16 6 7mg·L-1)、低 (1 6 7mg·L-1) 3个浓度的平均回收率分别为 10 0 19% ,97 4 5 % ,95 5 1% ;日内、日间RSD均 <5 % (n =5 ) ;分析方法的最低检测浓度为 0 0 8mg·L-1。线性范围为 0 83～ 16 6 6 7mg·L-1,回归方程为Y =0 0 2 16X - 0 0 0 333,r=0 9999(n =10 )。结论 :该方法可用于临床TZD血药浓度监测和药动学研究     

Hair loss with antidepressants

A 68-year-old woman complained of hair loss whilst taking fluoxetine which ceased when the drug was discontinued. This prompted a review of similar reports with other antidepressant drugs and it was found to have occurred with five representative tricyclic compounds and all four 5-HT uptake-inhibitors available in the UK. There were no reports of hair loss with trazodone or mianserin. Although extremely rare (0.01 per cent) hair loss has important social and psychological implications in the treatment of depression.     

Pharmacokinetic and pharmacodynamic characteristics of a controlled-release formulation of trazodone versus the conventional formulation in healthy volunteers

The pharmacokinetic and pharmacodynamic characteristics of a controlled-release (CR) formulation of trazodone were evaluated in healthy subjects who received acutely 150 mg and 75 mg of the CR trazodone and equal amounts of the conventional formulation on separate occasions. Plasma trazodone concentrations were measured by HPLC. The pharmacokinetic profile of CR trazodone was characterized by a slower increase in drug plasma levels and a lower and retarded peak plasma concentration without any modification in the total amount of trazodone absorbed over 24 hrs. The side effects were less severe and less frequent than with the conventional formulation.

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Sommario Le caratteristiche farmacocinetiche e farmacodinamiche di una formulazione di trazodone a rilascio controllato (CR) sono state studiate in volontari sani ai quali furono somministrati, in quattro differenti occasioni, 150 mg e 75 mg di trazodone CR e dosi equivalenti di trazodone in formulazione convenzionale. Le concentrazioni plasmatiche di trazodone furono misurate mediante HPLC. Rispetto alla formulazione convenzionale, il trazodone CR esibì un profilo farmacocinetico caratterizzato da un incremento più graduale dei livelli plasmatici e da una concentrazione massima più bassa e più ritar-data. Nessuna differenza nella quantità totale di farmaco assorbita nelle 24 ore fu osservata tra le due formulazioni. Dopo somministrazione del trazodone CR, gli effetti collaterali indesiderati furono meno severi e meno frequenti rispetto alla formulazione convenzionale.

     

Effects of trazodone on polysomnography, blood concentration and core body temperature in healthy volunteers

Polysomnography, blood concentration and core body temperature recordings were performed on 12 healthy volunteers with administration of trazodone and placebo. Trazodone increased slow wave sleep (SWS), and decreased the average, the highest and lowest core body temperature significantly compared to placebo. The blood concentration of trazodone correlated positively with amplitude (the difference between the highest and lowest temperature) and %SWS during the first period of a sleep phase divided into three periods, and negatively with the lowest temperature. The appearance time of the lowest temperature correlated negatively with %SWS.     

Randomly study on erectile dysfunction treated by trazodone

Objective: To observe the efficacy and tolerance of Trazodone in Treating erectile dysfunction (ED). Methods: 65 patients were randomly assigned into two groups. Patients in Trazodone group were treated with trazodone from 50 mg a day gradually increased 150 mg a day over 4 weeks. Patients in control group were given placebo. The IIEF~*.5 was used to evaluate the effects before and after interference. Results: the effective rates were 40%, while the response rates of control group were 16.7%. There was significant difference in trazodone group before and after treatment. The side effects were slight dizziness, fatigue and sleepness. Conclusions: Administration of Trazodone significantly improved the sexual function in patients suffered from mild and moderate ED.     

曲唑酮与帕罗西汀治疗焦虑症病人睡眠障碍的比较

目的 :比较曲唑酮和帕罗西汀对焦虑症病人睡眠障碍的疗效。方法 :4 5例焦虑症病人随机分为 2组。曲唑酮组 2 2例 ,给予曲唑酮 5 0～ 10 0mg·d- 1,qn× 8wk。帕罗西汀组 2 3例 ,给予帕罗西汀2 0～ 4 0mg·d- 1,qn× 8wk。结果 :睡眠障碍因子评分 :在 1wk时 ,曲唑酮组 3.0±s 1.7,帕罗西汀组4 .0± 1.6 ;在 2wk时 ,曲唑酮组 1.3± 1.2 ,帕罗西汀组 2 .3± 1.3(均P <0 .0 5 )。总睡眠时间 :2组比较在 1wk时差异有非常显著意义 (P <0 .0 1) ;在 2wk时差异有显著意义 (P <0 .0 5 )。早醒现象 :2组比较在 2 ,4wk时差异均有显著意义 (P <0 .0 5 )。睡眠增多、嗜睡不良反应分别为 0 / 2 3,6 / 2 2 (P <0 .0 5 )。结论 :曲唑酮比帕罗西汀改善睡眠见效早、作用快、作用强 ,睡眠时间长 ,早醒现象轻     

西肽普兰合并曲唑酮治疗老年抑郁症疗效观察

目的:探讨西肽普兰合并曲唑酮治疗老年抑郁症的临床疗效。方法:将74例老年抑郁症患者随机分为治疗组(西肽普兰服用剂量为20～40 mg.d-1合并曲唑酮服用剂量50～150 mg.d-1)及对照组(单用西肽普兰)各37例,疗程6周。分别于治疗后1、2、6周末用汉密尔顿抑郁量表,汉密尔顿焦虑量表评定疗效,以症状量表(TESS)评定治疗中出现的不良反应。结果:2组治疗后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)总分比较差异有统计学意义(P<0.05),治疗组的不良反应比对照组重,主要表现有头昏、嗜睡,但患者均能耐受。结论:西肽普兰合并曲唑酮治疗抑郁症比对照组临床疗效更好。