Initial dose: 150 mg orally per day in divided doses; this may be increased by 50 mg orally per day every 3 to 4 days Maximum dose: -Inpatients: 600 mg/day -Outpatients: 400 mg/day Comments: -Patients should be screened for a personal/family history of bipolar disorder, mania, or hypomania prior to initiating treatment. -Patients should be monitored for withdrawal symptoms when discontinuing therapy. -After an adequate response has been reached, dosage may be gradually reduced depending on therapeutic response. -If drowsiness develops, a major portion of the daily dose may be administered at bedtime or a reduction of dosage may be necessary. -This drug should be taken shortly after a meal or light snack. Use: Treatment of major depressive disorder (MDD) Use with caution. 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Also, trazodone showed anxiolytic properties, low cardiotoxicity, and relatively mild side effects. Because trazodone has minimal anticholinergic activity, it was especially welcomed as a treatment for geriatric patients with depression when it first became available. Three double-blind studies reported trazodone has antidepressant efficacy similar to that of other antidepressants in geriatric patients. However, a side effect of trazodone, orthostatic hypotension, which may cause dizziness and increase the risk of falling, can have devastating consequences for elderly patients; thus, this side effect, along with sedation, often makes trazodone less acceptable for this population, compared with newer compounds that share its lack of anticholinergic activity but not the rest of its side-effect profile. Still, trazodone is often helpful for geriatric patients with depression who have severe agitation and insomnia. 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