Box 2 Different forms of trazodone present options to tailor treatment based on individual patient symptoms and requirements

• Oral immediate-release (IR) seems well-suited for treating mild to moderate major depression in patients with initial insomnia or periods of agitation or irritability during specific times of the day, as it can achieve higher blood concentration peaks at those times [45]

• Slow release (SR, sometimes called delayed or controlled release) may meet the needs of patients with mild to moderate major depression, both initial and central insomnia, and moderate to severe daytime or nighttime anxiety. It results in blood concentration peaks that are lower but sustained compared to the IR form, and higher but more rapidly declining peaks than the once-daily ER formulation [46]

• Once a day extended release (ER, also known as XR or COAD) ensures a consistent release of trazodone over 24 h and is appropriate for managing major depression accompanied by early, central, or late insomnia, as well as daytime or nocturnal anxiety, including severe depression requiring continuous maintenance of therapeutic blood levels [20, 21]

• Intramuscular-intravenous (IM-IV) solutions might be beneficial for patients who cannot take oral medications [47]