Trazodone in the Management of Sundowning Syndrome of Dementia: A Clinical Perspective
| Author | Arash Askari Noghani | en |
| Author | Zanireh Salimi | en |
| Author | Reza Bidaki | en |
| Author | Farshad Abedi | en |
| Orcid | Arash Askari Noghani [0000-0001-7395-4639] | en |
| Orcid | Zanireh Salimi [0000-0003-3973-4741] | en |
| Orcid | Reza Bidaki [0000-0002-5482-9143] | en |
| Orcid | Farshad Abedi [0000-0001-7133-820X] | en |
| Issued Date | 2026-09-30 | en |
| Abstract | Context: Sundowning syndrome is a common and challenging neuropsychiatric complication of dementia, characterized by late-day agitation and sleep disturbances. This clinical perspective reviews the potential role of trazodone in managing sundowning by aligning its pharmacological profile with the underlying pathophysiology of this condition. Evidence Acquisition: A selective review of the current literature was conducted, focusing on the neurobiological mechanisms of sundowning, particularly circadian rhythm disruption and serotonergic dysfunction, as well as on clinical evidence regarding the use of trazodone for dementia-related behavioral and sleep disturbances. Results: Trazodone, a serotonin antagonist and reuptake inhibitor with potent sedative effects, has a distinct profile for managing evening agitation. Its ability to modulate sleep–wake cycles through histamine H1 and α1-adrenergic blockade, combined with its effects on serotonergic pathways, makes it a compelling candidate for treating sundowning. This article discusses the pharmacological relevance of trazodone, compares its clinical utility with other psychotropic options, and outlines key clinical considerations, including dosing, safety, and tolerability in the geriatric population. Conclusions: Trazodone may be a pharmacological option for managing sundowning syndrome; however, large-scale randomized controlled trials are needed to confirm its safety and efficacy in this specific clinical context. | en |
| DOI | https://doi.org/10.5812/ijpbs-173068 | en |
| URI | https://brieflands.com/journals/ijpbs/articles/173068 | en |
| Keyword | Behavioral Symptoms | en |
| Keyword | Psychomotor Agitation | en |
| Keyword | Sundowning Syndrome | en |
| Keyword | Trazodone | en |
| Publisher | Brieflands | en |
| Title | Trazodone in the Management of Sundowning Syndrome of Dementia: A Clinical Perspective | en |
| Type | Review Article | en |
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