The antidepressant monotherapy with trazodone achieves an effective response after only one week with a single daily dose starting at 150 mg. The multifunctional antidepressant mechanism of action of the serotonin antagonist and reuptake inhibitor (SARI) has no significant effects on body weight and libido.
The launch of Trittico® Uno is a milestone in antidepressant monotherapy with trazodone. Thanks to the new galenics, consisting of modified starch with high amylose content, this innovative technology allows easy dosing and controlled release over 24 hours. A single dose of up to 300 mg of trazodone per day results in stable plasma levels within the therapeutic range for 24 hours.
Trazodone is a triazolopyridine-derived antidepressant that acts via serotonin 2A and 2C (5HT2A/2C) receptor antagonism and via inhibition of serotonin reuptake. Since its introduction as an atypical antidepressant with unique pharmacological properties, trazodone has been shown to be equivalent to other drug classes in several comparative studies. Immediate-release trazodone is prescribed primarily as a hypnotic in doses of 50 to 200 mg. At these low doses, immediate-release formulations achieve plasma concentrations sufficient to exploit sedative effects as a result of 5HT2A and H1 receptor antagonism but are not sufficiently sustained to induce an antidepressant effect. To achieve an antidepressant effect, higher daily doses must be followed if they are to sufficiently inhibit 5HT2A and 5HT2C receptors and block the serotonin transporter [1].
Need for effective therapies
Natural history studies have shown that only one-third of patients with major depression achieve remission after a single course of antidepressant treatment. Even after one year of four consecutive treatments with different antidepressants, only about two-thirds of patients with depression achieved remission. Another major limitation associated with the use of antidepressants is their delayed onset of action. It usually takes 4 to 6 weeks for the full therapeutic effect to manifest. Therefore, faster-onset antidepressants with improved tolerability that are free of initial activating/anxiety effects are urgently needed to improve treatment. It was shown that the antidepressant efficacy of trazodone correlated significantly with its steady-state plasma levels. Therefore, formulations of trazodone with different release rates may show a different course of efficacy in the mid- and long-term treatment of a depressive episode. Trazodone is a once-daily antidepressant with rapid onset of action and efficacy in treating symptoms of anxiety and insomnia, while possibly avoiding weight gain, sexual dysfunction, and activating side effects [2].
Fast and significant response
Trittico® Uno shows a rapid and significant response after only one week [1,2]. This was demonstrated in a large-scale, placebo-controlled, double-blind clinical trial, as well as confirmed by a real-world study in a practice-based setting [1,3]. The good safety profile also speaks for itself: adverse drug reactions were mostly mild to moderate and transient.
Source: OM Pharma Suisse AG
Literature:
- Sheehan DV, et al: Extended-release Trazodone in Major Depressive Disorder: A Randomized, Double-blind, Placebo-controlled Study. Psychiatry 2009; 6(5): 20-33.
- Albert U, Lamba P, Stahl SM: Early response to trazodone once-a-day in major depressive disorder: review of the clinical data and putative mechanism for faster onset of action. CNS Spectr. 2021; 26(3):232-242.
- Češková E, Šedová M, Kellnerová R, Starobová O: Once-a-Day Trazodone in the Treatment of Depression in Routine Clinical Practice. Pharmacology 2018; 102(3-4): 206-212.
InFo NEUROLOGY & PSYCHIATRY 2022; 20(4): 7.
