[Trazodone Contramid® in clinical practice: personalizing antidepressant intervention].

AIM This paper examines the use of Trazodone Contramid® in major depressive disorder (MDD), with a focus on practical guidance regarding real world challenges. The paper includes clinical case reports, developed for didactic reasons, which detail the practical management with Trazodone Contramid® of patients with MDD and either insomnia or anxiety or dementia or isolated (ipo)manic symptoms, which often fulfill the criteria for a diagnosis of MDD with with anxious distress or MDD with mixed features, according to the new DSM-5 classification. METHODS A literature search was performed using appropriate keywords to identify studies where any formulation of trazodone was used. The reference lists of those studies identified were cross-referenced for additional studies. RESULTS Based on the literature search and our clinical experience, we report that trazodones may be particularly useful in those forms of depression with comorbid anxiety or insomnia or isolated manic symptoms or dementia. DISCUSSION Trazodone has proven an effective medication in patients with MDD but has not been extensily studied in terms of its efficacy for specific phenotypes of depression. Hereby we report that Trazodone Contramid® may be particularly effective in those forms of MDD that are characterized by comorbid insomnia, and/or anxiety, and/or isolated manic symptoms and/or dementia. These forms of depression are very common and a thorough knowledge of Trazodone Contramid® pharmacological properties will aid choosing and managing this medication at the best. CONCLUSIONS Trazodone contramid is a relatively new formulation of trazodone, which has proven effective in MDD, particularly in those difficult to treat cases of MDD characterized by symptoms such as insomnia, anxiety, dementia or (ipo)manic symptoms. The once-a-day formulation of trazodone may provide a combination of improved tolerability and efficacy over other antidepressants and over the conventional immediate-release formulation of the same medication.