Is trazodone a Selective Serotonin Reuptake Inhibitor (SSRI)?

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From the FDA Drug Label

The mechanism of trazodone’s antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS Trazodone is both a selective serotonin reuptake inhibitor (SSRI) and a 5HT2 receptor antagonist Trazodone Hydrochloride Tablets belongs to a class of medicines known as SSRIs (or selective serotonin reuptake inhibitors).

Trazodone is considered a Selective Serotonin Reuptake Inhibitor (SSRI), as it selectively inhibits neuronal reuptake of serotonin and is classified as an SSRI in the provided drug labels 1 1.

  • Key points:
    • Trazodone enhances serotonergic activity in the CNS.
    • It is both an SSRI and a 5HT2 receptor antagonist.
    • Classified as an SSRI in the drug labels.

From the Research

No, trazodone is not an SSRI (Selective Serotonin Reuptake Inhibitor), it is classified as a serotonin antagonist and reuptake inhibitor (SARI). Trazodone works differently from SSRIs, with its primary mechanism of action being the blocking of serotonin 2A receptors, in addition to some serotonin reuptake inhibition effects 2. This dual action gives trazodone its unique properties, making it effective for both depression and insomnia.

Key Differences from SSRIs

  • Trazodone is typically prescribed at doses of 50-150 mg for insomnia and 150-400 mg for depression, often taken at bedtime due to its sedating effects.
  • Unlike SSRIs, trazodone usually doesn't cause sexual side effects or weight gain, making it a preferred option for some patients.
  • Trazodone has different side effects, drug interactions, and therapeutic uses compared to SSRIs, such as being more commonly used as a sleep aid but potentially less effective for anxiety disorders.

Clinical Evidence

A recent study published in 2023 compared the effectiveness of trazodone in extended release formulation to SSRIs in patients with major depressive disorder, finding that trazodone was more effective in reducing the severity of depression, anxiety, and insomnia 2. This study highlights the potential benefits of trazodone over SSRIs in certain aspects of treatment.

Mechanism of Action

Trazodone's mechanism of action is distinct from SSRIs, with a potent antagonist action at 5-HT2/1C receptors, which is in contrast to the primary action of SSRIs as inhibitors of 5-HT uptake 3. This difference in mechanism underlies the unique clinical profile of trazodone.

Clinical Use

Trazodone is approved for the treatment of major depressive disorder and is also used off-label for insomnia, anxiety disorders, and other conditions, showcasing its versatility in clinical practice 4, 5. Its tolerability profile, including being weight-neutral and not decreasing sexual function, makes it a valuable option in the treatment of depression.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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