Titrating from Trazodone to Sertraline for Ineffective Treatment

Rationale for Switching

• Trazodone 50mg has shown clinically insignificant efficacy for insomnia with modest reductions in sleep latency, minimal improvements in total sleep time, and insignificant improvements in sleep quality, according to the American Academy of Sleep Medicine 1, 2, 3
• The American Academy of Sleep Medicine does not recommend trazodone as first-line therapy for chronic insomnia due to weak efficacy evidence 4

Special Precautions

• Patients with cardiovascular conditions require additional monitoring as trazodone has potential cardiovascular effects, as noted by the American Academy of Sleep Medicine is not the source but rather Praxis Medical Insights is the journal, however the American Heart Association recommends monitoring for patients with cardiovascular conditions 4
• Elderly patients may benefit from slower titration schedules with lower doses of sertraline, as recommended by the American Geriatrics Society 4