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Trazodone

Tarzan-bone
Picmonic
Trazodone is categorized as an atypical antidepressant medication, which is primarily indicated for insomnia. When administered at higher doses, it can be used as an antidepressant. The main mechanism of action by which trazodone works is it inhibits serotonin reuptake, but also displays serotonergic receptor antagonism.Side effects such as sedation and orthostatic hypotension are related to the α1 blockade effects of trazodone.  Another serious, male-specific, side effect of this medication is priapism, which is defined as an erection lasting longer than 4 hours.
10 KEY FACTS
INDICATIONS
Insomnia
Taped-awake-insomniac

Trazodone has strong sleep-inducing (hypnotic) effects and is primarily indicated for insomnia.

Depression
Depressed-emo

Trazodone can also be used, in higher doses, in the treatment of major depressive disorder (MDD).

MECHANISM OF ACTION
Inhibit Serotonin Reuptake
Inhibiting-chains on Silver-tonic Reuptake-tube

Trazodone works to balance serotonin levels in depressed patients primarily in two ways. First, trazodone is considered a weak serotonin reuptake inhibitor, whereby it delays the metabolism of serotonin in the post-synaptic cleft so there is more neurotransmitter available for use, the same mechanism of action utilized in SSRIs. Secondly, it potently inhibits the excitatory receptors of 5-HT2A, which are more numerous in depressed patients.

Alpha-1 Blocker
Afro (1) Wand Block-guy

Though the mechanism isn't fully understood, part of trazodone's effects are attributed to the drug's α1-adrenergic receptor blocking activity.

Histamine (H1) Blocker
History-man (1) Wand and Block-guy

This medication also inhibits histamine, or H1, receptors. It is thought that this effect is responsible for the associated sedation, which proves beneficial for use as a sleep aid.

SIDE EFFECTS
Sedation
Sedation-dart

A common side effect of trazodone is sedation, largely thought to result from the histamine (H1) receptor blockade.

Orthostatic Hypotension
Oar Hippo-BP

Trazodone may cause orthostatic hypotension in some patients, possibly due to its blockage of α1-adrenergic receptors.

Dry Mouth
Cotton Mouth

While trazodone's antihistamine effect proves useful in treating insomnia, it can also commonly cause dry mouth as a side effect.

Priapism
Pitching-a-tent

Priapism is a side effect of trazodone that is a common exam question regarding potential adverse effects of this medication and may be remembered by the mnemonic, TrazoBONE. This male-specific condition occurs when the erect penis does not return to the flaccid state within four hours and is thought to be facilitated by trazodone's inhibition of α1-adrenergic receptors.

Arrhythmias
Broken-arrhythmia-drum

While it remains a rarely seen side effect, it is important to be aware that there have been cases of atrial and ventricular arrhythmias in patients treated with trazodone. As such, exercise caution when considering prescribing trazodone to cardiac patients.

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