Trazodone can be used to treat which combination of conditions?

• A. Major depressive disorder with insomnia
• B. Bipolar depression without sleep disturbance
• C. Panic disorder with agoraphobia
• D. Generalized anxiety disorder only

Answer: (A)

Trazodone is a antidepressant with strong sedating effects, so it’s particularly useful when depression and sleep disturbance occur together. Its action as a serotonin reuptake inhibitor with additional antagonism at 5-HT2 receptors, plus histamine H1 blockade, helps lift mood while also promoting sleep. In someone with major depressive disorder who also has insomnia, trazodone tackles both problems with one medication, improving daytime functioning and overall mood by addressing the sleep disruption that often compounds depressive symptoms.

Why the other scenarios aren’t the best fit: for bipolar depression, antidepressants can risk triggering mania if mood stabilization isn’t in place, so trazodone isn’t typically the first-line choice when sleep is not the dominant issue. For panic disorder with agoraphobia, the core treatment targets are panic symptoms and avoidance, usually with SSRIs/SNRIs and psychotherapy rather than a drug whose primary benefit is sleep. For generalized anxiety disorder alone, there are more effective anxiolytics and antidepressants (like SSRIs/SNRIs or buspirone) as first-line; trazodone’s strength is its sleep-related benefit, not anxiety control by itself.