Abstract
Purpose
This study sought to describe patient characteristics and treatment patterns among
patients with insomnia prescribed trazodone in the United States.
Methods
This real-world, retrospective, descriptive cohort study used US commercial insurance
claims from July 1, 2009, through June 30, 2019. The index date was the first prescription
for trazodone between January 1, 2010, and December 31, 2018, with 6 months for the
preindex period and ≥6 months for the postindex period.
Findings
Among 5.8 million patients with insomnia, 17.7% were prescribed trazodone, and 357,380
adults (6.2%) and 7564 children (0.1%) met the study eligibility criteria. The mean
(SD) age was 48.8 (15.8) years for adults and 14.8 (2.7) years for pediatrics. Most
patients were female (229,280 adults [64.2%] and 4481 children [59.2%]). Insomnia
due to mental disorder was the most common specific diagnosis. The most common (>25%)
comorbid conditions were anxiety, depression, and hypertensive disease, and 1 of 10
had a history of substance abuse. Zolpidem was previously prescribed (73,342 adults
[20.5%] and 233 children [3.1%]) and continued to be prescribed. Concomitant antidepressants
were most common (216,893 adults [60.7%] and 5414 children [71.6%]), but benzodiazepines
(132,740 adults [37.1%] and 1188 children [15.7%]), antiepileptics (115,064 adults
[32.2%] and 2103 children [27.8%]), nonbenzodiazepines (90,946 adults [25.4%] and
542 children [7.2%]), and antipsychotics (40,490 adults [11.3%] and 2063 children
[27.3%]) were also prescribed.
Implications
This study provides current evidence that trazodone use is widespread among patients
with insomnia and is often associated with other specific comorbidities, such as psychiatric
conditions. A deeper knowledge of the real-world management of patients with insomnia
may facilitate steps toward improving sleep quality, daytime functioning, and clinical
outcomes for patients.
Key words
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Article info
Publication history
Published online: August 27, 2022
Accepted:
July 13,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
