Serotonin antagonist & reuptake inhibitor (SARI)
Trazodone hydrochloride
Brand names: Molipaxin
Adult dose
Dose: Initial 150mg/day PO in divided doses, increase to 300mg/day; max 600mg/day inpatient
Route: PO
Frequency: divided or ON
Clinical pearls
- Depression with anxiety/insomnia; agitation in dementia (low-dose nocte off-label per NICE NG97)
- Less sexual dysfunction than SSRIs
Contraindications
- Recent MI
- Concurrent MAOI
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Sedation
- Postural hypotension
- Priapism
- Cardiac arrhythmia
- Hyponatraemia
- Serotonin syndrome
Interactions
- MAOIs
- SSRIs/SNRIs
- CNS depressants
- CYP3A4 modulators
- QT-prolonging drugs
Monitoring
- Mood
- Na+
- ECG
Reference: BNF; NICE NG222/NG97; https://bnf.nice.org.uk/drugs/trazodone-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF