BACKGROUND: Depression is the leading cause of lowering the quality of life of cancer patients and lung cancer is the most likely to cause depression. It is necessary to find out depression-related factors in lung cancer patients. METHODS: The study was a retrospective cohort study using medical records, and was a non-equivalent comparison group design. It involved patients diagnosed of lung cancer at the Konkuk University Medical Center from January to December 2012. Between antidepressants prescription group and non prescription group, socio-demographic factors, clinical factors, treatment-related factors and other factors were analyzed statistically. RESULTS: Antidepressant prescription group consisted of 23 people and non-prescription group of 206 people. Prescription rate of quetiapine was the highest 47.8% (11/23), followed by escitalopram (43.5%, 10/23), amitryptyline and trazodone (30.4%, 7/23). The prescription group was prescribed with an average of 1.9 antidepressants. Antidepressants were prescribed after average of 248 days from lung cancer diagnosis and prescription period per patient was average 177.5 days. According to the result of univariate logistic regression analysis between 2 groups, factors such as number of outpatient visit, number of admission, days of hospitalization, sleep disorder, and comorbidity were found to be statistically significant (p < 0.05). However, According multivariate logistic regression analysis showed that number of admission, days of hospitalization and sleep disorder were statistically significant (p < 0.05) excluding comorbidity. CONCLUSION: About 10% of lung cancer patients had received a prescription for antidepressants after lung cancer diagnosis. A sleep disorder, number of hospitalization and length of stay were identified as factors influencing the prescribing antidepressants.
Academic Medical Centers ; Antidepressive Agents* ; Citalopram ; Cohort Studies ; Comorbidity ; Depression ; Diagnosis ; Hospitalization ; Humans ; Length of Stay ; Logistic Models ; Lung Neoplasms* ; Lung* ; Medical Records ; Outpatients ; Prescriptions ; Quality of Life ; Quetiapine Fumarate ; Retrospective Studies ; Sleep Wake Disorders ; Trazodone

OBJECTIVETo study the clinical effects of the Chinese drug Yimusake, used alone or in combination with trazodone hydrochloride, on primary premature ejaculation (PE).

METHODSSixty-eight primary PE patients were randomized to a control (n=32) and an experimental group (n=36), the former treated with Yimusake 1 tablet (50 mg) pre day, and the latter with 1 tablet of trazodone hydrochloride (50 mg) pre day in addition, both given orally after supper and for 4 weeks, followed by observation of the therapeutic effects.

RESULTSEighteen cases (56.25%) responded in the control and 25 (69.44% ) in the experimental group, with statistically significant difference between the two groups (P<0.05).

CONCLUSIONYimusake combined with trazodone hydrochloride is highly efficacious for primary PE.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine ; Male ; Phytotherapy ; Premature Ejaculation ; drug therapy ; Trazodone ; therapeutic use ; Treatment Outcome ; Young Adult

BACKGROUND AND OBJECTIVES: Burning mouth syndrome (BMS) refers to a collection of symptoms of patients who complain about burning sensation of their mouths without any specific causes. Although this is not a rare disease, the etiology and effective treatment are not well established. We tried to compare the efficacy and side effects of the agents that are reported to be relatively effective to BMS. SUBJECTS AND METHOD: Fifty-one patients who were diagnosed as BMS were chosen as candidates. Trazodone, Paroxetine, Clonazepam, and Gabapentin, which were known to be effective medicines for BMS in previous research were prescribed randomly. We prescribed medication for two weeks and evaluated patients for the effect and side effects at the end of the treatment. The medication was prescribed for 2 more weeks and the patients were evaluated again. RESULTS: Three of 11 (27.3%) patients were prescribed Trazodone, 8 of 12 (66.7%) Paroxetine, 8 of 14 (57.1%) Clonazepam and 12 of 14 (85.7%) Gabapentin. Q showed improvements after 4 weeks of medication. The differential effectiveness among the medications was not significant, except for the inferiority of Trazodone. Five of 11 (45.5%) patients who had been prescribed Trazodone, 2 of 12 (16.7%) who had been prescribed Paroxetine, 2 of 14 (14.3%) who had been prescribed Clonazepam, 2 of 14 (14.3%) who had been prescribed Gabapentin complained of side effects during 4 weeks of medication. CONCLUSION: We can expect high success rates of treatment for burning mouth syndrome with Paroxetine, Clonazepam and Gabapentin. A further study for long term outcomes and side effects in large groups is warranted.
Amines ; Burning Mouth Syndrome ; Burns ; Clonazepam ; Cyclohexanecarboxylic Acids ; gamma-Aminobutyric Acid ; Humans ; Mouth ; Paroxetine ; Rare Diseases ; Sensation ; Trazodone

OBJECTIVETo compare the therapeutic effects of insomnia accompanied with depressive disorders treated by acupuncture of relieving depression and regulating mind and oral administration of Trazodone.

METHODSSixty-five cases were randomly divided into a acupuncture group (33 cases) and western medication group (32 cases). In acupuncture group, Shenmen (HT 7), Baihui (CV 20), Hegu (LI 4) and Taichong (LR 3) were selected. In western medication group, Trazodone was applied with oral administration for 4 weeks. The curative effect comparison was carried on by Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), and Side Effect Rating Scale (SERS) of Asberg.

RESULTSThe cured and markedly effective rate of 72.7% (24/33)in acupuncture group was superior to that of 46.8% (15/32) in western medication group; after treatment, the scores of all items and the total cumulative scores of PSQI and SDS of both groups were reduced (P < 0.01, P < 0.05), of which, the sleep quality and daytime function evaluation in acupuncture group reduced more obviously than those in western medication group (both P < 0.05); the SERS scores of Asberg in western medication group were higher than those in acupuncture group.

CONCLUSIONAcupuncture treatment of relieving depression and regulating mind is superior to Trazodone with oral administration for sleep quality and daytime function, with milder adverse reactions.

Acupuncture Therapy ; Adult ; Depressive Disorder ; drug therapy ; therapy ; Female ; Humans ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; drug therapy ; therapy ; Trazodone ; therapeutic use ; Young Adult

Purpose: This study was done to assess the therapeutic effect of trazodone, an antidepressant agent in combination with sildenafil in patients with erectile dysfunction (ED) and decreased libido with normal serum testosterone level. Materials and Methods: From March 2005 to February 2006, 90 patients with ED complaining of decreased libido but whose serum testosterone level was within normal range were screened and enrolled in this study. The subjects were randomly treated by sildenafil only (group 1) and combination of sildenafil with trazodone (group 2). Patients received trazodone for at least 3 consecutive months, with daily doses starting at 50 mg. By intention-to-treat basis, the period of study was extended by 9 month. The intention-to-treat population included 39 sildenafil recipients and 35 sildenafil with trazodone recipients. The patients were asked to make up two questions, Q1: 'Did you experience improvement of erection after treatment?' and Q2: 'Did you experience improvement of libido after treatment?' and the change of International index of erectile function (IIEF) scores before and after the treatment were analyzed to assess the efficacy of treatment. Results: After 3 month treatment period, 70% of group 1 and group 2 answered 'yes' to Q1. Twenty seven percents of group 1 and 51% of group 2 answered 'yes' to Q2 and 20% of group 1 and 24% of group 2 answered 'yes' to both Q1 and Q2. In the intention-to-treat population, seventy-two percents of group 1 and 71% of group 2 answered 'yes' to Q1 and 28% of group 1 and 52% of group 2 answered 'yes' to Q2, 21% of group 1 and 26% of group 2 answered 'yes' to both Q1 and Q2. The change of IIEF scores before and after the treatment at 3 month and 9 month showed similar results. Both group 1 and group 2 showed significant improvement on scores of IIEF-5 and question 15 of IIEF after treatment (p<0.01). Meanwhile, only group 2 showed significant improvement on question 11 and 13 of IIEF after the treatment compared to group 1 (p<0.05). Two patients with high dose of trazodone complained of headache and drowsiness, but the symptoms disappeared by dose reduction. Conclusions: The combination therapy of trazodone with sildenafil increased libido and sexual satisfaction on patients with ED. Therefore, combination of trazodone with sildenafil might be considered in ED patients of decreased libido with normal serum testosterone level rather than sildenafil monotherapy.
Erectile Dysfunction ; Headache ; Humans ; Libido ; Male ; Piperazines ; Purines ; Reference Values ; Sleep Stages ; Sulfones ; Testosterone ; Trazodone ; Sildenafil Citrate

The mortality and morbidity in tricyclic antidepressants (TCAs) overdose still remained high due to fatal cardiac toxicities despite their decreased prescriptions. Also, monoamine oxidase inhibitors (MAOIs) may show relatively high cardiac toxicities in excess or mixed overdoses. Selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants have been known to be safe in overdose until recently. However, many researchers have found that SSRIs and newer antidepressants also showed serious and fatal toxicities in case of excess or mixed overdoses. Citalopram or escitalopram overdoses showed a relatively high incidence of cardiac toxicity with a dose-dependent manner. Also, venlafaxine, bupropion and trazodone overdoses showed significant cardiac toxicities, although degrees of the toxicities are different each other. Especially, venlafaxine's pattern and incidence of cardiac toxicities are the similar to those of TCAs. Mirtazapine and reboxetine show no significant toxicities in overdose although the present toxicological data are insufficient. To conclude, assessment of compliance, pharmacology education for patients and effective treatment may reduce the incidence and severity of toxicities in overdose.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Bupropion ; Citalopram ; Compliance ; Cyclohexanols ; Humans ; Incidence ; Mianserin ; Monoamine Oxidase Inhibitors ; Morpholines ; Prescriptions ; Serotonin Uptake Inhibitors ; Trazodone ; Venlafaxine Hydrochloride

OBJECTIVE: Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician's experience. The goal of this study was to examine and compare the trend of prescription patterns for major depressive disorder at a university hospital between year 2001 and 2006. METHODS: We evaluated the medication usage of inpatients with major depressive disorder in 2001 and 2006, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the time to switching and combination of antidepressant in 2001 and 2006. RESULTS: The antidepressants used as first line drug were SSRIs (49.3%), mirtazapine (24.0%), and TCAs (4.8%) in 2001, and SSRIs (50.0%), mirtazapine (24.7%) and venlafaxine (19.0%) in 2006, in frequency order. The antidepressants used as switching drug were TCAs (33.3%), mirtazapine (25.0%), and nefazodone (16.7%) in 2001, and SSRIs (33.3%), mirtazapine (33.3%), and venlafaxine (19.0%) in 2006. As combination treatment, SSRIs and TCAs combination was used mostly by far in 2001 (87.5%), but in 2006, various combination were used including SSRIs and mirtazapine, SSRIs and TCAs, mirtazapine and venlafaxine (36.8%, 23.6%, 18.4%, respectively). The time to combination in 2001 and 2006 year were not different significantly (17.4+/-7.9 day vs 18.0+/-12.9 day, respectively; p=0.829) but the time to switching was significantly shorter in 2006 than in 2001 (13.1+/-7.5 day vs 24.1+/-11.7day; p=0.009). The use of typical antipsychotics as augmentation agent decreased and the use of atypical antipsychotics increased significantly in 2006. Most frequently used atypical antipsychotic was quetiapine in 2006. The use of thyroid hormone and trazodone were significantly decreased in 2006, but the use of mood stabilizer was not changed between 2001 and 2006. While the use of lithium decreased, the use of lamotrigine increased in 2006. CONCLUSION: The results of the present study suggested that there were lots of change in prescription patterns for major depressive disorder between 2001 and 2006. Especially, these changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics and lamotrigine. It can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of treatment of depression.
Antidepressive Agents ; Antipsychotic Agents ; Depression ; Depressive Disorder, Major* ; Humans ; Inpatients* ; Lithium ; Prescriptions ; Psychopharmacology ; Thyroid Gland ; Trazodone ; Quetiapine Fumarate ; Venlafaxine Hydrochloride

OBJECTIVE: Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician's experience. The goal of this study was to examine and compare the trend of prescription patterns for major depressive disorder at a university hospital between year 2001 and 2006. METHODS: We evaluated the medication usage of inpatients with major depressive disorder in 2001 and 2006, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the time to switching and combination of antidepressant in 2001 and 2006. RESULTS: The antidepressants used as first line drug were SSRIs (49.3%), mirtazapine (24.0%), and TCAs (4.8%) in 2001, and SSRIs (50.0%), mirtazapine (24.7%) and venlafaxine (19.0%) in 2006, in frequency order. The antidepressants used as switching drug were TCAs (33.3%), mirtazapine (25.0%), and nefazodone (16.7%) in 2001, and SSRIs (33.3%), mirtazapine (33.3%), and venlafaxine (19.0%) in 2006. As combination treatment, SSRIs and TCAs combination was used mostly by far in 2001 (87.5%), but in 2006, various combination were used including SSRIs and mirtazapine, SSRIs and TCAs, mirtazapine and venlafaxine (36.8%, 23.6%, 18.4%, respectively). The time to combination in 2001 and 2006 year were not different significantly (17.4+/-7.9 day vs 18.0+/-12.9 day, respectively; p=0.829) but the time to switching was significantly shorter in 2006 than in 2001 (13.1+/-7.5 day vs 24.1+/-11.7day; p=0.009). The use of typical antipsychotics as augmentation agent decreased and the use of atypical antipsychotics increased significantly in 2006. Most frequently used atypical antipsychotic was quetiapine in 2006. The use of thyroid hormone and trazodone were significantly decreased in 2006, but the use of mood stabilizer was not changed between 2001 and 2006. While the use of lithium decreased, the use of lamotrigine increased in 2006. CONCLUSION: The results of the present study suggested that there were lots of change in prescription patterns for major depressive disorder between 2001 and 2006. Especially, these changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics and lamotrigine. It can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of treatment of depression.
Antidepressive Agents ; Antipsychotic Agents ; Depression ; Depressive Disorder, Major* ; Humans ; Inpatients* ; Lithium ; Prescriptions ; Psychopharmacology ; Thyroid Gland ; Trazodone ; Quetiapine Fumarate ; Venlafaxine Hydrochloride

The diverse effects of antidepressants on sleep are mediated by their agonistic or antagonistic properties on specific neurotransmitters: the catecholamine, serotonergic, cholinergic, and histaminergic neurotransmitter systems, which also regulate the timing and cycling of sleep. Therefore, antidepressants can have both class- and compound-specific effects on sleep/wake dynamics, sleep stages, and on motor control during sleep. For these reasons, the sedating or wake-promoting effects of these medications are important factors influencing specific drug selection. As these sleep-related effects may in turn influence both medication compliance as well as the course of the disease state itself, it is important for clinicians to understand and predict the possible effects of antidepressants on sleep. Some antidepressants, such as amitriptyline, doxepine, trazodone, and mirtazapine, possess sedating properties and improve sleep continuity via alpha-1 adrenoceptors and histamine H1 receptor blockade, combined with 5HT(2A/2C) receptor blockade. Other antidepressants, such as SSRI, SNRI and MAOIs, worsen sleep and may cause insomnia, an effect which may be linked to facilitation of 5HT(2A/2C) receptors. The majority of antidepressants are REM (rapid eye movement) suppressants, though some, such as nefazodone, bupropion, and mirtazapine, lack REM-suppressing effects. On the other hand, the effects of antidepressants on slow wave sleep (SWS) are much less consistent than their effects on REM sleep. Available data suggest that antidepressants, including some TCAs, and trazodone, increase SWS, possibly as a function of their 5-HT(2A/2C) receptor antagonism. In contrast, antidepressants lacking 5-HT(2A/2C) receptor antagonist effects, including SSRIs, SNRIs and MAOIs, may produce no change or even decrease in SWS. Knowledge of the effects of antidepressants on sleep will be helpful in estimating the sleep disturbance caused by these compounds, and can thus help in the selection of appropriate compound for individual patients.
Amitriptyline ; Antidepressive Agents* ; Bupropion ; Doxepin ; Hand ; Humans ; Medication Adherence ; Neurotransmitter Agents ; Receptors, Adrenergic ; Receptors, Histamine H1 ; Sleep Initiation and Maintenance Disorders ; Sleep Stages ; Sleep, REM ; Trazodone

Trazodone has favorable pharmacological profiles with a few anticholinergic effects and cardiac conduction abnormailties. Thus it is more acceptable in geriatric population than tricyclic antidepressant (TCA) especially in patients with combined medical conditions, although attention should be paid to monitor its well-known side effects, orthostatic hypotension and priapism. Unlike expected favorable profiles, we had experienced a case of increased intraocular pressure (IOP) shortly after lowdose trazodone treatment in a known-glaucoma patient.
Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Hypotension, Orthostatic ; Intraocular Pressure ; Priapism ; Trazodone*