These findings suggest that adjunctive trazodone was associated with better sleep-related and clinical outcomes, as well as higher circulating 5-HT and BDNF levels, than fluvoxamine monotherapy.
Key Findings
Results
In this propensity-score-matched retrospective study, adjunctive trazodone with fluvoxamine was associated with better sleep architecture than fluvoxamine alone.
156 propensity-score-matched patients with depression were analyzed: 78 received fluvoxamine monotherapy (control) and 78 received trazodone plus fluvoxamine (observation).
Both regimens were continued for 8 consecutive weeks.
The observation group showed significantly reduced awake time and prolonged REM sleep and slow-wave sleep (SWS) duration compared with controls.
Results
The observation group had improved sleep quality compared with the control group.
The abstract reports 'improved sleep quality' in the trazodone plus fluvoxamine group relative to fluvoxamine monotherapy.
Sleep outcomes were assessed at prespecified clinical time points.
Results
Depression and anxiety scores were lower in the trazodone combination group at week 4.
HAMD at week 4: 8.23 ± 1.25 (observation) vs. 11.88 ± 2.50 (control), P < 0.001.
HAMA at week 4: 4.35 ± 1.32 (observation) vs. 7.89 ± 2.17 (control), P < 0.001.
Results
Circulating 5-HT and BDNF levels were higher in the trazodone combination group at week 8.
Higher circulating 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) levels were reported in the observation group compared with the control group at week 8.
Results
The overall clinical response rate was significantly higher with adjunctive trazodone than with fluvoxamine monotherapy.
The abstract states the overall clinical response rate was 'significantly higher in the observation group than in the control group'; specific rates are not given in the abstract.
Methods
Propensity score matching was used to balance baseline characteristics between groups in this retrospective design.
The study was retrospective, and the findings are described as associations rather than causal effects.
PSM yielded 78 patients per group for the final analysis.
What This Means
This study looked back at medical records of 156 people with depression who were treated for 8 weeks. Half took the antidepressant fluvoxamine alone, and half took fluvoxamine plus trazodone, a medication often used for sleep and depression. The two groups were matched on baseline characteristics using a statistical method to make them more comparable.
People who also took trazodone had less time awake during the night, more REM and slow-wave (deep) sleep, and better sleep quality. By week 4 their depression and anxiety scores were lower (for example, HAMD 8.23 vs. 11.88 and HAMA 4.35 vs. 7.89). By week 8 they also had higher blood levels of serotonin (5-HT) and BDNF, a protein linked to brain health, and a higher overall clinical response rate.
This research suggests that adding trazodone may be linked to better sleep and symptom outcomes than fluvoxamine alone. Because the study was retrospective rather than a randomized trial, it shows an association and cannot prove that trazodone caused the improvements. Prospective trials would be needed to confirm these results.
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Li J, Li L, Li Q, Zhang S, Bian Y. (2026). Adjunctive Trazodone Effects on Sleep, Mood, and Circulating 5-HT and BDNF in Depression.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/73296