Oral Trazodone as empirical therapy for erectile dysfunction: A retrospective review
ABSTRACT Anecdotal reports of increased libido and sexual function in patients taking trazodone have led to its empirical use in patients with erectile dysfunction. A retrospective review of patient-reported responses to trazodone was performed to outline the efficacy and side-effect profile of this agent.
Between 1989 and 1994, 182 patients were placed on oral trazodone as empirical therapy for erectile dysfunction. Patients ranged in age from 26 to 85 years, with a mean of 60 years. Patients were evaluated before receiving trazodone with a thorough medical history and physical examination. Known risk factors for erectile dysfunction were assigned based on historical information and the findings of the examination. Patients received trazodone for at least 2 consecutive months, with daily doses starting at 25 mg.
One hundred twenty-seven patients were available for follow-up by a standardized questionnaire regarding perceived improvement in erectile function, sexual function, and side effects. In patients less than 60 years of age, with no known risk factors for erectile dysfunction, 21 of 27 (78%) showed significant improvement in erectile ability. Smokers and patients older than 60 years with a history of significant peripheral vascular disease responded poorly to trazodone therapy. The duration of erectile dysfunction was inversely related to a response to trazodone. Of patients with a duration of impotence less than 12 months, 48% reported a positive response. Only 16% of patients with duration of erectile dysfunction greater than 60 months reported improvement in erections and sexual function. Trazodone was well tolerated by this population, with 62% reporting no side effects.
Despite the limitations of a nonrandomized, retrospective study, trazodone appears to benefit younger patients with erectile dysfunction with few known risk factors. A prospective, placebo-controlled trial is needed to confirm the observations of this pilot study.
- SourceAvailable from: Amjad Alwaal
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- "Serotonin exerts a general inhibitory effect on male sexual function, although it can produce an excitatory or inhibitory effect on the erectile function, depending on the action at different sites and different serotonin receptors.52 Trazodone, a selective serotonin agonist, has been reported to have a stimulatory effect on erection.53 The 5-HT2C receptor was found to be the main serotonin mediator for erection.54 "
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ABSTRACT: Many drugs are known to alter normal male sexual function. In most instances, this is an undesirable effect and every effort is made to minimize the sexual adverse effects of therapeutic pharmacological agents. The effort to use medications that have minimal risk for disruption of sexual function is complicated by the development and introduction of multiple medications for chronic vascular and neurological disease. Patient compliance can be problematic when a therapeutic agent interferes with sexual function and serious complications have been seen when patients discontinue their medications because, in their minds, the medications are interfering with their sexuality. This chapter attempts to enhance the practioners knowledge of the sexual adverse effects associated with multiple classes of therapeutic agents commonly used in medicine today.01/1970: pages 155-193;
Article: Priapism: Etiology and Management[Show abstract] [Hide abstract]
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