Trazodone in the Management of Major Depression Among Elderly Patients with Dementia: A Narrative Review and Clinical Insights

Andrea Fagiolini; Ana González Pinto; Kamilla Woznica Miskowiak; Pedro Morgado; Allan H Young; Eduard Vieta

doi:10.2147/NDT.S434130

Trazodone in the Management of Major Depression Among Elderly Patients with Dementia: A Narrative Review and Clinical Insights

Neuropsychiatr Dis Treat. 2023 Dec 21:19:2817-2831. doi: 10.2147/NDT.S434130. eCollection 2023.

Authors

Andrea Fagiolini¹, Ana González Pinto^{2

3}, Kamilla Woznica Miskowiak^{4

5}, Pedro Morgado^{6

7

8}, Allan H Young^{9

10}, Eduard Vieta¹¹

Affiliations

¹ Department of Molecular and Developmental Medicine, Division of Psychiatry, University of Siena School of Medicine, Siena, 53100, Italy.
² Bioaraba Research Institute, Department of Psychiatry, Araba University Hospital, Vitoria, 01004, Spain.
³ CIBERSAM, University of the Basque Country, Vitoria, Spain.
⁴ Neurocognition and Emotion in Affective Disorders Centre (NEAD), Psychiatric Centre Copenhagen, Mental Health Services, Copenhagen, Denmark.
⁵ Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
⁶ Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, 4710-057, Portugal.
⁷ ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, 4710-057, Portugal.
⁸ Clinical Academic Center-Braga (2CA), Braga, 4710-243, Portugal.
⁹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
¹⁰ South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK.
¹¹ Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.

Abstract

Objective: Major depressive disorder (MDD) often co-occurs with dementia and other neurological disorders, and treatment with antidepressants can improve symptoms, quality of life, and survival in these patients. This narrative review provides an expert opinion about the role and effectiveness of trazodone in the treatment of older adults with MDD and cognitive impairment due to physical illnesses, such as dementia.

Results: Because of its mechanism of action, trazodone can treat several depression symptoms often seen in people with dementia, including insomnia, agitation, anxiety, cognitive impairment, and irritability.

Conclusion: Trazodone may be beneficial for patients with dementia or other neurological disorders comorbid with MDD, especially when the clinical picture of depression includes or is comorbid to symptoms of insomnia, irritability, inner tension, anxiety, or psychomotor agitation.

Keywords: cognitive impairment; dementia; depression; major depressive disorder; trazodone.

Grants and funding

Angelini Pharma S.p.A. sponsored an expert meeting from which this manuscript arose. Angelini also provided financial support to Ethos srl, which provided editorial support to the authors in the preparation of the manuscript. This has not impacted the content of the manuscript in any way.