Desyrel (Trazodone)

This novel antidepressant is chemically unrelated to tricyclic, tetracyclic, or other antidepressants. How Desyrel works is not fully understood, but it is believed to inhibit serotonin uptake.

Desyrel should be taken with food or shortly after a meal or light snack to lower the risk of dizziness or lightheadedness. You may be more apt to feel dizzy or lightheaded if you take the drug before you have eaten. The recommended initial dose is 150 milligrams daily. This may be increased every few days by 50 milligrams a day to a maximum daily dose of 600 milligrams. Once you have responded well to Desyrel, your doctor may gradually reduce your dose.

 

Side Effects

Unlike antidepressants such as Prozac that may leave you pacing die floor at night, Desyrel can have you sleeping like a baby. Because of Desyrel's sedative qualities, it's often added to other drugs such as Prozac if insomnia becomes problematic.

On the downside, Desyrel may cause a rare but nasty side effect called priapism, a painful erection without sexual arousal. Priapism occurs when blood doesn't drain from the penis's spongy tissue, keeping it erect. Urgent treatment is needed in this case because of the risk of permanent damage to the penis. (Some patients have experienced permanent impairment of erection or impotence.) Desyrel has also been linked to some heart problems.

Other side effects include dry mouth (34 percent), dizziness (28 percent), blurred vision (15 percent), and nausea (13 percent).

You may need to undergo blood tests since this drug can reduce your white blood cell count. (White blood cells are an important part of the body's immune system; low levels could be a problem if you develop an infection, sore throat, or fever.) Because of the link between Desyrel and some heart problems, your doctor may ask you to have blood pressure readings and electrocardiograms.

If you get too sleepy or dizzy, ask your doctor if you can take a larger portion of your total dose at bedtime, dividing the rest into two or three smaller doses during the day. Be extra cautious about driving, using machinery, or engaging in any activities that require alertness, judgment, or physical coordination until you and your doctor feel reasonably confident that the drug does not impair your abilities.

Drug Interactions

If Desyrel is taken with certain drugs, the effects of either may be increased, decreased, or altered. Desyrel may intensify the effects of alcohol, so you should not combine it with alcoholic beverages. It is especially important to check with your doctor before combining Desyrel with any of the following:

•  Barbiturates such as Seconal
• Central nervous system depressants such as Demerol or Halcion
• Chlorpromazinc (Thorazine)
• Digoxin (Lanoxin)
• Drugs for high blood pressure such as Catapres and Wytensin
• Other antidepressants such as Prozac and Norpramin
• Phenytoin (Dilantin)
• Warfarin (Coumadin)
• Little is known about the interaction between Desyrel and general anesthetics; therefore, this drug should be discontinued prior to elective surgery.

 

Pregnancy and Breast-feeding

Because some animal studies have revealed fetal deaths and birth defects, Desyrel is not recommended during the first three months of pregnancy- The effects of Desyrel during human pregnancy have not been adequately stud­ied. You and your doctor should weigh the potential risks to the fetus and to you before deciding whether or not to take antidepressants during pregnancy.

Desyrel may appear in breast milk (it has been found in lactating rats). If this drug is essential to your health, your doctor may advise you to discontinue breast-feeding until your treatment is finished.

Brand name: Desyrel Generic name: Trazodone Synonyms: Beneficat, Bimaran, Desirel, Molipaxin, Pragmazone, Sideril, Thombran, Tombran, Trazalon, Trazodil Description:

Desyrel is used for treating depression. It may also be used for relief of an anxiety disorder (eg, sleeplessness, tension), chronic pain. It may also be used for other conditions as determined by your doctor. Desyrel is a tetracyclic antidepressant. It is thought to increase the activity of one of the brain chemicals (serotonin), which helps elevate mood.

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trazodone (cont.)

PRESCRIBED FOR: Trazodone is primarily used for the treatment of depression. It is sometimes prescribed as a sedative, and it also is used in combination with other drugs for the treatment of panic attacks, aggressive behavior, agoraphobia, and cocaine withdrawal.

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GENERIC NAME: trazodone

BRAND NAME: Desyrel

DRUG CLASS AND MECHANISM: Trazodone is an oral antidepressant drug that affects the chemical messengers (neurotransmitters) within the brain that nerves use to communicate with (stimulate) each other. The major neurotransmitters are acetylcholine, norepinephrine, dopamine and serotonin. Many experts believe that an imbalance among the different neurotransmitters is the cause of depression. Although the exact mechanism of action of trazodone is unknown, it probably improves symptoms of depression by inhibiting the uptake of serotonin by nerves in the brain. This results in more serotonin to stimulate other nerves. Trazodone also may increase directly the action of serotonin. Trazodone is chemically unrelated to the selective serotonin reuptake inhibitors (SSRIs), the tricyclic antidepressants (TCAs) or the monoamine oxidase inhibitors (MAO inhibitors). It is chemically related to nefazodone (Serzone) and shares its actions. Trazodone was approved by the FDA in 1982.