ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2018
Comparative risk of harm associated with trazodone or atypical antipsychotic use in older adults with dementia: a retrospective cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- The Effects of Exergaming on the Depressive Symptoms of People With Dementia: A Systematic Review and Meta-Analysis.Journal of clinical nursing · 2025Pooled it
- Bipolar Disorder and Manic-Like Symptoms in Alzheimer's, Vascular and Frontotemporal Dementia: A Systematic Review.Current neuropharmacology · 2023Pooled it
- Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- Safety of pharmacologic interventions for neuropsychiatric symptoms in dementia: a systematic review and network meta-analysis.BMC geriatrics · 2020Pooled it
- Substitution Patterns After Discontinuation of CNS-Active Medications in Older Adults in Primary Care.Journal of the American Geriatrics Society · 2026Article
- Variation in Psychotropic and Non-Psychotropic Prescribing in Nursing Homes: A Multi-Level EMR-Based Retrospective Cohort Study.Journal of the American Geriatrics Society · 2026Article
- Safety outcomes of trazodone versus antipsychotics for delirium after hospital admission in adults aged 65 years and older: a nationwide cohort study using a target trial emulation framework.The lancet. Healthy longevity · 2025Article
- Changes in Sedative Use in British Columbia, Canada from 2012 to 2021: A Drug Utilization Study.Journal of general internal medicine · 2025Article
- Comparative Risk of Harm Associated with Zopiclone or Trazodone Use in Nursing Home Residents: a Retrospective Cohort Study in Alberta, Canada.Canadian geriatrics journal : CGJ · 2023Article
- Melatonin for Insomnia in Medical Inpatients: A Narrative Review.Journal of clinical medicine · 2022Review
- Falls, healthcare resources and costs in older adults with insomnia treated with zolpidem, trazodone, or benzodiazepines.BMC geriatrics · 2022Article
- Antidepressants and Vertebral and Hip Risk Fracture: An Updated Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2022Review
- Targeting the Unfolded Protein Response as a Disease-Modifying Pathway in Dementia.International journal of molecular sciences · 2022Review
- Article
- Hip fracture predicts subsequent hip fracture: a retrospective observational study to support a call to early hip fracture prevention efforts in post-fracture patients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Observational
- Comparison of Medication Prescribing Before and After the COVID-19 Pandemic Among Nursing Home Residents in Ontario, Canada.JAMA network open · 2021Observational
- Effectiveness of confidential reports to physicians on their prescribing of antipsychotic medications in nursing homes.Implementation science communications · 2020Article
- Psychotropic drugs for the behavioural and psychological symptoms of dementia: no free ride.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrazodone is increasingly prescribed for behavioural and psychological symptoms of dementia, but little is known about its risk of harm. Our objective was to describe the comparative risk of falls and fractures among older adults with dementia dispensed trazodone or atypical antipsychotics.
methodsThe study cohort included adults with dementia (excluding patients with chronic psychotic illnesses) living in long-term care and aged 66 years and older. Data were obtained from routinely collected, linked health administrative databases in Ontario, Canada. We compared new users of trazodone with new users of atypical antipsychotics (quetiapine, olanzapine or risperidone) between Dec. 1, 2009, and Dec. 31, 2015. The primary outcome was a composite of fall or major osteoporotic fracture within 90 days of first prescription. Secondary outcomes were falls, major osteoporotic fractures, hip fractures and all-cause mortality.
resultsWe included 6588 older adults dispensed trazodone and 2875 dispensed an atypical antipsychotic, of whom 95.2% received a low dose of these medications. Compared with use of atypical antipsychotics, use of trazodone was associated with similar rates of falls or major osteoporotic fractures (weighted hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.73 to 1.07), major osteoporotic fracture (weighted HR 1.03, 95% CI 0.73 to 1.47), falls (weighted HR 0.91, 95% CI 0.75 to 1.11) and hip fractures (weighted HR 0.92, 95% CI 0.59 to 1.43). Use of trazodone was associated with a lower rate of mortality (weighted HR 0.75, 95% CI 0.66 to 0.85).
interpretationTrazodone is not a uniformly safer alternative to atypical antipsychotics, given the similar risk of falls and fractures among older adults with dementia.
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