Molipaxin (Trazodone Hydrochloride)

Molipaxin (trazodone hydrochloride) acts on the serotonergic system and is used for several psychiatric conditions.

• Major depressive disorder: alleviates depressive symptoms and improves overall mood.
• Insomnia: promotes sleep onset and maintenance in patients with difficulty sleeping.
• Anxiety associated with depression: reduces anxiety symptoms when used as an adjunct to antidepressant therapy.

• Trazodone hydrochloride inhibits the reuptake of serotonin at neuronal synapses, increasing extracellular serotonin levels, and antagonizes 5‑HT2A receptors. This dual action enhances serotonergic neurotransmission while moderating excitatory pathways, contributing to its antidepressant and hypnotic effects.

Trazodone may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Drowsiness: feeling unusually sleepy during the day.
• Dry mouth: reduced salivation leading to discomfort.
• Headache: mild to moderate cranial pain.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Nausea: upset stomach or urge to vomit.
• Blurred vision: temporary visual disturbances.

Serious or Rare Side Effects

• Priapism: prolonged, painful erection requiring immediate medical attention.
• Cardiac arrhythmia: irregular heart rhythm that may be life‑threatening.
• Serotonin syndrome: potentially fatal condition when combined with other serotonergic drugs.
• Severe hypotension: sudden drop in blood pressure causing faintness.
• Hepatic injury: signs of liver dysfunction such as jaundice.
• Allergic reactions: rash, swelling, or breathing difficulty.

Before initiating therapy, clinicians should consider several safety measures.

• Assess hepatic function: evaluate liver enzymes as trazodone is metabolized hepatically.
• Monitor for suicidal ideation: especially during early treatment of depression.
• Avoid abrupt discontinuation: taper the dose to reduce withdrawal symptoms.
• Caution in elderly: increased fall risk due to sedation and orthostatic hypotension.
• Avoid concomitant MAO inhibitors: risk of severe serotonin syndrome.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Trazodone can interact with other medicines, altering its safety or effectiveness.

Major Interactions (Avoid)

• MAO inhibitors: concurrent use may precipitate serotonin syndrome.
• Other serotonergic agents (e.g., SSRIs, SNRIs, triptans): increase risk of serotonin toxicity.
• Strong CYP3A4 inhibitors (e.g., ketoconazole): raise trazodone plasma levels.

Moderate Interactions (Monitor Closely)

• CNS depressants (e.g., benzodiazepines, alcohol): additive sedation.
• Antihypertensive drugs: potential for enhanced blood‑pressure lowering effect.