Analysis of factors affecting laboratory alert level of trazodone based on therapeutic drug monitoring data.

AIMS: Previous studies have revealed the importance of therapeutic drug monitoring for personalized trazodone dosing. However, studies on risk factors related to trazodone plasma concentrations that exceed laboratory alert levels are lacking. This study aimed to identify the factors influencing the trazodone plasma concentration-to-dose (C/D) ratio in the Chinese population. Additionally, it attempted to comprehensively investigate the factors contributing to trazodone concentrations exceeding 1200 ng/mL.

METHODS

A single-center, retrospective, cross-sectional study was conducted at Xi'an Mental Health Center in China, where data on Trazodone-treated patients between 2020 and 2023 were collected.

RESULTS

The C/D ratios of trazodone were significantly influenced by age, the formulations of trazodone, and the concomitant use of fluvoxamine. Additionally, the results revealed that 21.67 % of patients receiving daily trazodone doses of 25-200 mg demonstrated plasma concentrations exceeding laboratory alert levels. A logistic regression analysis using a enter method determined patient older age [1.04 (95 CI: 1.01-1.07)], higher daily dose [1.04 (95 CI: 1.02-1.05)], higher total protein level [1.10 (95 CI: 1.02-1.19)] and concomitant use of fluvoxamine [7.99 (95 CI: 2.48-25.72)] as risk factors for surpassing laboratory alert levels in plasma concentrations.

CONCLUSION

In conclusion, this study provides important and valuable clinical results for future personalized trazodone administration. Keywords trazodone, therapeutic drug monitoring, laboratory alert level, related factors.