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Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

2023; Elsevier BV; Volume: 14; Issue: 3 Linguagem: Inglês

10.1007/s41999-023-00790-1

1878-7657

Alessandra Coin, Marianna Noale, Pietro Gareri, Caterina Trevisan, Andrea Bellio, Filippo Fini, Angela Marie Abbatecola, Stefania Del Signore, Alba Malara, Enrico Mossello, Stefano Fumagalli, Stefano Volpato, Fabio Monzani, Giuseppe Bellelli, Gianluca Zia, Raffaele Antonelli Incalzi, Angela Marie Abbatecola, Domenico Andrieri, Rachele Antognoli, Raffaele Antonelli Incalzi, M Antonietti, Viviana Bagalà, Giulia Bandini, Salvatore Bazzano, Giuseppe Bellelli, Andrea Bellio, Federico Bellotti, Enrico Benvenuti, Marina Bergamin, Marco Bertolotti, Carlo Biagini, Angelo Bianchetti, Alessandra Bianchi, Mariangela Bianchi, Paola Bianchi, Francesca Biasin, Silvia Bignamini, Damiano Blandini, Stefano Boffelli, Cristiano Bontempi, Alessandra Bordignon, Luigi Maria Bracchitta, Maura Bugada, Carmine Cafariello, Veronica Caleri, Valeria Calsolaro, Donatella Calvani, Francesco Antonio Campagna, Andrea Capasso, Sebastiano Capurso, Silvia Carino, Giovanna Elisiana Carpagnano, Barbara Carrieri, Viviana Castaldo, Manuela Castelli, Manuela Castellino, Alessandro Cavarape, Ilaria Cazzulani, Carilia Celesti, Chiara Ceolin, Maria Giorgia Ceresini, Arcangelo Ceretti, Antonio Cherubini, Anita Chizzoli, Erika Ciarrocchi, Paola Cicciomessere, Alessandra Coin, M. Colombo, Annalisa Corsi, Antonella Crispino, Roberta Cucunato, Carlo Custodero, Federica D’Agostino, Maria Maddalena D’Errico, Ferdinando D’Amico, Aurelio De Iorio, Alessandro De Marchi, Annalaura Dell’Armi, Marta Delmonte, Giovambattista Desideri, Maria Devita, Evelyn Di Matteo, Emma Espinosa, Luigi Esposito, Chiara De Fazio, Christian Ferro, Chiara Filippini, Filippo Fini, Lucia Fiore, Serafina Fiorillo, Caterina Fontana, Lina Forte, Riccardo Franci Montorzi, Carlo Fumagalli, Stefano Fumagalli, Pietro Gareri, Pier Paolo Gasbarri, Antonella Giordano, Evelina Giuliani, Roberta Granata, Antonio Greco, Nadia Grillo, Antonio Guaita, Liana Gucciardino, Andrea Herbst, Marilena Iarrera, Giuseppe Ielo, Valerio Alex Ippolito, Antonella La Marca, Umberto La Porta, Ilaria Lazzari, Diana Lelli, Yari Longobucco, Francesca Lubian, Giulia Lucarelli, Flaminia Lucchini, Daniela Lucente, Lorenzo Maestri, Marcello Maggio, Paola Mainquà, Mariangela Maiotti, Alba Malara, Carlotta Mancini, Irene Mancuso, Eleonora Marelli, Alessandra Marengoni, Eleonora Marescalco, Benedetta Martin, Valentina Massa, Giulia Matteucci, Irene Mattioli, Liliana Mazza, Carmela Mazzoccoli, Fiammetta Monacelli, Paolo Moneti, Fabio Monzani, Federica Morellini, Maria Teresa Mormile, Enrico Mossello, Chiara Mussi, Francesca Nigro, Marianna Noale, Chukwuma Okoye, Giuseppe Orio, Sara Osso, Chiara Padovan, Annalisa Paglia, Giulia Pelagalli, Laura Pelizzoni, Agostino Perri, Maria Perticone, Giacomo Piccardo, Alessandro Picci, Margherita Pippi, G. Provenzano, Matteo Pruzzo, Francesco Raffaele Addamo, Cecilia Raffaelli, Francesca Remelli, Onofrio Resta, Antonella Riccardi, Daniela Rinaldi, Renzo Rozzini, Matteo Rubino, Carlo Sabbà, Leonardo Sacco, Mariateresa Santoliquido, Mariella Savino, Francesco Scarso, Giuseppe Sergi, Gaetano Serviddio, Claudia Sgarito, Giovanni Sgrò, Chiara Sidoli, Federica Sirianni, Vincenzo Solfrizzi, Benedetta Soli, Debora Spaccaferro, Fausto Spadea, Laura Spadoni, Laura Tafaro, Luca Tagliafico, Andrea Tedde, Camilla Terziotti, Giuseppe Dario Testa, Maria Giulia Tinti, Francesco Tonarelli, Elisabetta Tonon, Caterina Trevisan, Rita Ursino, Filomena Vella, Maria Villanova, Aurora Vitali, Stefano Volpato, Francesca Zoccarato, Sonia Zotti, Amedeo Zurlo,

Intensive Care Unit Cognitive Disorders

To comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants in a large dataset from the GeroCovid Observational multiscope and multisetting study. 10.8% out of 3396 persons included used trazodone and the 8.5% other antidepressants; the use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to long-term care facilities or living at home. Conditions associated with trazodone use included depression, dementia and behavioral and psychological symptoms of dementia. The present data suggest an off-label use of trazodone as a possible therapeutic option in the challenging field of behavioral and psychological disturbances in older adults with dementia. Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD.