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Trazodone in the elderly: risk of extrapyramidal acute events
  1. Joana Sotto Mayor,
  2. Ana Paula Pacheco,
  3. Sofia Esperança,
  4. Antonio Oliveira e Silva
  1. Department of Internal Medicine, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Joana Sotto Mayor, s.mayor.joana{at}


Trazodone is a second-generation atypical antidepressant exercising selective inhibitory action on the transport of serotonin. It also has an antagonist effect, similar to nefazodone, on the 5HT1 and 5HT2 receptors, probably due to the therapeutic effects of such substances. It is very effective in the treatment of depression, in anxiety and insomnia. Its known side effects mainly occur with prolonged use of daily doses of 150–200 mg. The ability to enhance drowsiness may be associated with some risk in elderly patients. This clinical case illustrates an acute extrapyramidal event induced by a low dose of trazodone.

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