Use of Trazodone in the Management of Psychomotor Agitation in Dementia Syndromes

• DOI: https://doi.org/10.22533/at.ed.1594962429103

• Palavras-chave: Trazodone; Dementia; Psychomotor Agitation; Neuropsychiatric Symptoms; Pharmacological Treatment.

• Keywords: Trazodone; Dementia; Psychomotor Agitation; Neuropsychiatric Symptoms; Pharmacological Treatment.

• Abstract: RESUME INTRODUCTION The introduction outlines the significant challenge that psychomotor agitation presents in dementia patients, highlighting the prevalence of agitation in various forms of dementia, including Alzheimer's and Lewy body disease. It emphasizes the importance of finding safer pharmacological options beyond traditional antipsychotics, given their serious side effects. Trazodone, with its sedative properties and relatively safer profile, is proposed as a promising alternative for managing agitation, particularly in elderly dementia patients with multiple comorbidities. OBJETIVE To review and evaluate the efficacy and safety of trazodone in managing psychomotor agitation in dementia syndromes, comparing it with other pharmacological agents, and analyzing its role in reducing caregiver burden and improving patient outcomes. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Trazodone” OR “Psychomotor Agitation” OR “Dementia Syndromes” OR “Pharmacological Management” OR “Neuropsychiatric Symptome” in the last  years. RESULTS AND DISCUSSION The review discusses the efficacy of trazodone in reducing psychomotor agitation in dementia, particularly in Alzheimer’s patients, where it has been shown to lower agitation scores without the risks posed by antipsychotics. Comparisons between trazodone and other pharmacological agents indicate that trazodone is effective with fewer side effects, especially in long-term management. Its benefits in improving sleep and reducing caregiver burden are also highlighted. However, the review notes that trazodone’s slower onset of action limits its use in acute settings, and higher doses may pose risks of sedation and falls. Additionally, caution is advised in its use in Lewy body dementia due to potential worsening of motor symptoms and hallucinations. CONCLUSION Trazodone emerges as a valuable treatment for psychomotor agitation in dementia, offering a safer alternative to antipsychotics, particularly in long-term care. While its benefits in controlling agitation and reducing caregiver burden are clear, careful titration and monitoring are necessary to minimize risks such as sedation and falls. Further large-scale studies are needed to establish clear dosing guidelines and to fully understand its long-term safety and efficacy in this population. Trazodone’s role in the management of agitation in dementia, especially when combined with non-pharmacological interventions, warrants ongoing investigation to optimize patient outcomes.