Its bioavailability is 65 to 80%. Peak blood levels of trazodone occur 1 to 2 hours after ingestion and peak levels of the metabolite mCPP occur after 2 to 4 hours. Absorption is somewhat delayed and enhanced by food. Distribution
Trazodone is not sequestered into any tissue. The medication is 89 to 95% protein-bound. The volume of distribution of trazodone is 0.8 to 1.5 L/kg. Trazodone is highly lipophilic. Metabolism
The metabolic pathways involved in the metabolism are not well-characterized. In any case, the cytochrome P450 enzymes CYP3A4, CYP2D6, and CYP1A2 may all be involved to varying extents. Trazodone is known to be extensively metabolized by the liver via hydroxylation, N-oxidation, and N-dealkylation. Several metabolites of trazodone have been identified, including a dihydrodiol metabolite (via hydroxylation), a metabolite hydroxylated at the para position of the meta-chlorophenyl ring (via CYP2D6), oxotriazolepyridinepropionic acid (TPA) and mCPP (both via N-dealkylation of the piperazinyl nitrogen mediated by CYP3A4), and a metabolite formed by N-oxidation of the piperazinyl nitrogen. CYP1A2, CYP2D6, and CYP3A4 genotypes all do not seem to predict concentrations of trazodone or mCPP. In any case, there are large interindividual variations in the metabolism of trazodone. In addition, poor metabolizers of dextromethorphan, a CYP2D6 substrate, eliminate mCPP more slowly and have higher concentrations of mCPP than do extensive metabolizers.mCPP is formed from trazodone by CYP3A4 and is metabolized via hydroxylation by CYP2D6 (to a para-hydroxylated metabolite). It may contribute to the pharmacological actions of trazodone.
Identity disorder in the DSM was first listed as a separate diagnosis in version III (1980). In the DSM-IV (1994), it was replaced by "Identity problem", which was not defined as a mental disorder per se, but was listed in a chapter containing problems that might be a focus of clinical attention. Identity disorder was downgraded to Identity problem as research indicated that distress over ones identity is so common that it might very well be considered part of the normality. In practice, if a persons distress persisted or worsened, an Identity problem would often be succeeded by a diagnosis of an actual disorder, such as a mood disorder or borderline personality disorder. In DSM-5 (2013), Identity problem was removed. See also
Body integrity dysphoria, sometimes also called body integrity identity disorder
Dissociative identity disorder
Gender dysphoria, sometimes also called gender identity disorder
Self-concept
Self-image


== References ==