Possible trazodone potentiation of fluoxetine: a case series

Abstract

Background: Fluoxetine is an effective serotonin reuptake inhibitor antidepressant that can fail to alleviate either insomnia or major depression in a substantial minority of depressed patients. Trazodone has been reported to be both an effective nonbenzodiazepine hypnotic for antidepressant-associated insomnia and a possible serotonergic antidepressant adjunct. We present a case series of patients with variable responses when trazodone was added to fluoxetine.

Method: Eight consecutive depressed (DSM-III-R) patients taking fluoxetine were given trazodone either for sleep or as a possible antidepressant potentiator.

Results: Three (37.5%) of the eight patients (confidence interval = 4.0%-71.0%) had improvements in both sleep and depression. The remaining five patients either were unaffected by the addition of trazodone to fluoxetine or had intolerable adverse drug reactions.

Conclusion: Trazodone may be an effective hypnotic and antidepressant potentiator when combined with fluoxetine for some patients, but its use may be limited by adverse effects.