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.
"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 "
[Show abstract][Hide abstract] ABSTRACT: The treatment of erectile dysfunction (ED) has been revolutionized in the last 15 years with the introduction of type 5 phosphodiesterase (PDE5) inhibitors. Their efficacy, safety, and ease of administration have made them first-line treatment for ED. This article reviews the current therapies available for ED, and the new PDE5 inhibitors that are being investigated. Furthermore, it examines all the current ED treatment options that are in different phases of development (including oral and topical pharmacotherapy, gene therapy, and tissue engineering). A special emphasis is on avanafil, a new PDE5 inhibitor that has been studied extensively in Phase I and II clinical trials and has undergone several Phase III trials. Avanafil is a promising medication for ED due to its favorable pharmacokinetics, safety, and efficacy.
Drug Design, Development and Therapy 10/2011; 5:435-43. DOI:10.2147/DDDT.S15852 · 3.03 Impact Factor
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] ABSTRACT: Priapism is a urologic emergency. All patients should receive prompt urologic consultation. Management is based on prompt recognition, differentiation between low- and high-flow priapism, reversal of any potential precipitating factors, and the use of corporal aspirationhigation combined with intracavernosal α-agonist injection therapy. It cannot be overemphasized that severely prolonged erections are associated with the development of irreversible problems with erectile function and, therefore, immediate and aggressive management is mandatory.
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