Trazodone add-on in COVID-19-related SSRI-resistant post-traumatic stress disorder in healthcare workers: two case reports
Domenico De Berardis 1, 2*, Michele Fornaro 3, Antonio Ventriglio 4, Alessandro Valchera 5, Federica Vellante 2, Mauro Pettorruso 2, Giovanni Martinotti 2, Silvia Fraticelli 2, Massimo Di Giannantonio 2
1NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy, 2Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" Chieti, Italy, 3Department of Psychiatry, Federico II University, Naples, Italy, 4Department of Psychiatry, University of Foggia, Italy, 5"Villa S. Giuseppe" Clinic, Hermanas Hospitalarias, Ascoli Piceno, Italy
Received: November 8, 2020; Revised: February 17, 2021; Accepted: February 19, 2021; Published online: February 19, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
COVID-19 represents a significant stress factor for all people worldwide due to several factors, including quarantine, lockdowns, fear of contagion, deaths, and other traumatic events. However, the healthcare workers (HCWs) have paid the higher price of this pandemic in terms of fatalities, contagions, and psychological well-being. Studies suggest that this particular population is at increased risk of developing a severe post-traumatic stress disorder (PTSD). The early diagnosis and timely treatment of PTSD in HCWs may restore well-being and significantly impact health services functioning, reducing burnout, days spent far from work, disrupted personal and team empowerment, and worse job performances. In the present article, we reported on two cases of HCWs directly involved in the treatment of COVID-19 patients who showed SSRI-resistant PTSD, which was successfully treated with extended-release trazodone TRZ Contramid® add-on.
Keywords: Healthcare workers, COVID-19, PTSD, Trazodone, SSRIs, add-on

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