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曲唑酮的未批准用途:综述。

Off-label uses of trazodone: a review.

机构信息

University of Siena, Psychiatry Division, Department of Neuroscience, Viale Bracci 1, 53100 Siena, Italy.

出版信息

Expert Opin Pharmacother. 2012 Aug;13(12):1707-17. doi: 10.1517/14656566.2012.699523. Epub 2012 Jun 20.

Abstract

INTRODUCTION

Trazodone is an antidepressant belonging to the class of serotonin receptor antagonists and reuptake inhibitors. It is approved by the FDA for the treatment of depression. Insomnia is the most frequent reason for prescription of trazodone. It has also been proven useful in the treatment of anxiety disorders. Other off-label uses include the treatment of bulimia, benzodiazepine/alcohol dependence, fibromyalgia, central nervous system degenerative diseases (behavioral disorders in dementia and other organic disorders), schizophrenia, chronic pain disease and diabetic neuropathy, sexual dysfunction.

AREAS COVERED

This paper evaluates trazodone's efficacy and safety in its off-label uses. It also discusses the possibility that a combination of trazodone with SSRIs may prevent or treat some of the SSRI side effects, such as anxiety, insomnia and sexual dysfunction, in addition to synergically increasing SSRIs' antidepressant activity.

EXPERT OPINION

Few clinical trials have been conducted to evaluate trazodone's efficacy in the treatment of the diseases and symptoms for which it is often used in clinical practice. More studies are necessary to investigate possible new therapeutic indications, and to scientifically demonstrate the risk/benefit ratio for the many conditions for which trazodone is used, but not approved by the FDA.

摘要

简介

曲唑酮是一种抗抑郁药,属于 5-羟色胺受体拮抗剂和再摄取抑制剂。它已获得 FDA 批准,可用于治疗抑郁症。失眠是开曲唑酮处方最常见的原因。它也已被证明对治疗焦虑症有用。其他非适应证用途包括治疗贪食症、苯二氮䓬类药物/酒精依赖、纤维肌痛、中枢神经系统退行性疾病(痴呆和其他器质性疾病的行为障碍)、精神分裂症、慢性疼痛疾病和糖尿病性神经病、性功能障碍。

涵盖领域

本文评估了曲唑酮在非适应证中的疗效和安全性。它还讨论了曲唑酮与 SSRIs 联合使用的可能性,除了协同增加 SSRIs 的抗抑郁活性外,这种联合使用可能预防或治疗某些 SSRIs 的副作用,如焦虑、失眠和性功能障碍。

专家意见

很少有临床试验评估曲唑酮在治疗其在临床实践中常被用于治疗的疾病和症状方面的疗效。需要更多的研究来探索可能的新治疗适应证,并科学地证明曲唑酮在许多情况下的风险/收益比,这些情况是曲唑酮被用于治疗,但未获得 FDA 批准。

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