Catatonia in Outpatients

They evaluated insomniac individuals only (none with dementia) and observed significant impairment of short-term memory and verbal learning by assessments done in days 1 and 7 after onset of drug administration. It should be considered that short-term studies may not result in full development of the therapeutic effects of a drug with the inconvenience of revealing first-hand, usually transient adverse effects. Also, cognitive and psychomotor benefits experienced by healthy and demented volunteers can vary in magnitude and relevance in perspective of the nature and intensity of the impairment, ranging from substantial gains in performance (sustained or not) to a flatter slope of decline. In our scenario of a minimum follow-up of 3 weeks (including 2 weeks under intervention), witnessing no worsened performance at all among trazodone-treated compared to placebo-treated counterparts may contribute to assume trazodone as a safe drug in the context of cognitively compromised patient. To witness no change in cognitive functions regardless of the benefits of trazodone use in sleep parameters suggests that gains in the primary target do not necessarily translate into improvement of secondary goals, at least not in the settings described. Moreover, instructions regarding attainment to important sleep hygiene principles were discussed by the medical physician with all volunteers’ caregivers upon start of the interventional stage of the study. But our data reveal no change in the cognitive measures as result of these recommendations (placebo group), prompting for the discussion of whether behavioral strategies alone are to be considered before pharmacological intervention. To our knowledge, no study has examined the effect of trazodone on cognition in patients with AD. Among the limitations of our study, one may include that participation was restricted to AD patients with SD, being therefore difficult to extrapolate our findings to other dementia. Also, despite the rigorous execution of the study, assessing all possible cognitive dimensions was beyond the scope of our design, and make room for subsequent analyses. At last, the rather small and nonprobabilistic sample size could be viewed as a limitation. In conclusion, this study provides evidence that usage of trazodone 50 mg does not impact cognition after a 2-week treatment period of AD patients. More studies are needed to measure effects of trazodone on other cognitive dimension in older adults.