Personalized treatment of depression phenotypes: Role of trazodone in depression with insomnia

Aim. This paper completes a series of three manuscripts on the clinically relevant evidence of the use of trazodone in major depressive disorder. The first paper provided general clinical guidance on the use of trazodone in major depressive disorder. The second paper evaluated the different clinical scenarios in which trazodone prolonged-release or trazodone Contramid® once-a-day may be more indicated. This third and last paper evaluates the clinically relevant evidence about the use of trazodone in major depressive disorder (MDD) with insomnia. Methods. Medline and Cochrane Library searches were performed using the keywords 'trazodone' AND 'depression' AND 'insomnia', to identify the most relevant literature on the use of trazodone in patients with MDD and insomnia. European and the United States prescribing information was reviewed as well. More weight was given to the information that was deemed as most relevant for daily clinical practice. Results. Trazodone is an effective medication for patients with MDD and insomnia. Discussion. Trazodone is efficacious for the treatment of a broad array of depressive symptoms and is particularly useful for patients presenting with insomnia as one of the symptoms of depression. Conclusions. Trazodone improves sleep and depression and is particularly helpful for patients whose symptoms of depression include insomnia.