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The CMAJ (Canadian Medical Association Journal) has reported that trazadone use in the elderly may be associated with a risk of falls and major fractures.
Using claims data from ICES, researchers compared 6588 seniors given trazadone to 2875 receiving another atypical antipsychotic.
Compared other atypical antipsychotics, trazodone was associated with similar rates falls (23 falls per 100 patient years), and similar risks for major osteoporotic fracture (HR 1.03, 95% CI 0.73 to 1.47), falls (HR 0.91, 95% CI 0.75 to 1.11) and hip fractures (HR 0.92, 95% CI 0.59 to 1.43).
Trazodone was however, associated, with a lower rate of mortality (HR 0.75, 95% CI 0.66 to 0.85).
They found that patients dispensed trazadone had a rate of falls and major fractures, including hip fractures, similar to that of the group receiving atypical antipsychotics. However, trazadone was associated with a lower risk of death in these patients.