Is Trazodone Safer Than Benzodiazepines?

Low-dose trazodone often is prescribed to older patients with insomnia; presumably, clinicians perceive that drug to be safer than alternatives such as benzodiazepines. In this retrospective study, researchers used an Ontario database to calculate rates of serious falls in nursing home patients who received trazodone or benzodiazepines.

About 8000 new users of low-dose trazodone (median dose, 50 mg daily) were compared with a similar number of propensity score–matched new users of benzodiazepines. During the 90 days after drug initiation, incidence of fall-related emergency department visits or hospitalizations was 6% in each group. Rates of fall-related fractures also were similar in the two groups.