Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Trazodone: a non-hormonal alternative for neurovegetative climacteric symptoms
Hormone replacement therapy (HRT) is the treatment of choice for neurovegetative climacteric symptoms. In some women, however, HRT may either be contraindicated, or the patients themselves may prefer a non-hormonal form of treatment. Trazodone is a drug that acts as a weak, but specific, inhibitor of the uptake of 3H-serotonin and is generally used for its antidepressant effects. In this study we have observed the efficacy of oral Trazodone (75 mg/day) in the treatment of the climacteric symptoms in 25 menopausal patients recruited at the Menopause Clinic of Ferrara University Hospital. The symptoms were scored from 0 to 3 according to presence and intensity. The patients were all complaining of climacteric neurovegetative symptoms (average symptom score 2.43). Symptoms scores were recorded before starting treatment and then again after 3 months. The drug appeared to be particularly effective on the intensity of anxiety (OR: 0.08, CI: 0-0.080), insomnia (OR: 0.15, CI: 0.02-0.71), and irritability (OR: 0.29, CI: 0.04-1.48). The intensity of hot flushes appeared reduced but was not statistically significant (OR: 0.52, CI: 0.08-1.87). However, the average total score of symptoms appearing in the Kupperman scale was reduced (-14%) after treatment. Trazodone should be kept in mind. as possible alternative to HRT: This drug can be particularly useful for those patients whose climacteric symptoms have a marked connotation of anxiety rather than for hot flushes or when HRT are contraindicated.