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Observational Study
. 2023 Jun;14(3):465-476.
doi: 10.1007/s41999-023-00790-1. Epub 2023 May 19.

Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

Alessandra Coin  1 , Marianna Noale  2 , Pietro Gareri  3 , Caterina Trevisan  4   5 , Andrea Bellio  4 , Filippo Fini  4 , Angela Marie Abbatecola  6 , Stefania Del Signore  7 , Alba Malara  8 , Enrico Mossello  9 , Stefano Fumagalli  9 , Stefano Volpato  5 , Fabio Monzani  10 , Giuseppe Bellelli  11 , Gianluca Zia  7 , Raffaele Antonelli Incalzi  12 ; GeroCovid Observational Working Group
Collaborators, Affiliations
Observational Study

Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

Alessandra Coin et al. Eur Geriatr Med. 2023 Jun.

Abstract

Background and objectives: Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants.

Methods: This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use.

Results: Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression.

Discussion: The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD.

Keywords: BPSD, Profile, Clinical characteristics; Dementia; Depression; Trazodone.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Depression, dementia, and BPSD prevalence by clusters identified among TRAZ users
Fig. 2
Fig. 2
Summary of participants’ characteristics among clusters
See this image and copyright information in PMC

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