Patient demographics

Patient demographics

Source publication
Article
Full-text available
Purpose: We examined whether patients are appropriately screened for previous prolonged erections or priapism and counseled about trazodone complications, specifically prolonged erections and priapism, prior to trazodone treatment. Materials and methods: We identified patients under the age of 50 on trazodone as of February 27, 2019 at the VA Ne...

Contexts in source publication

Context 1
... for prescribing trazodone were insomnia, depression or posttraumatic stress disorder in all cases. Dosages of trazodone administered ranged from 50-100 mg, two to three times a day (Table 1). Prior to prescribing trazodone, only 43/229 (18.78%) of patients were informed about the side effects of prolonged erections. ...
Context 2
... case report of an individual with schizoaffective disorder discusses recurrent priapism over a three year period, each time related to the ingestion of quetiapine [18]. More recently, a case series from the AMSP (Arzneimittelsicherheit in der Psychiatrie) database reviews 19 case reports of priapism Asked about previous prolonged erection/priapism Informed about risk of prolonged erection Informed about risk of priapism Incidence of prolonged erections Incidence of priapism Reporting rate to physician about side effect 17/229 (7.42) 43/229 (18.78) 37/229 (16.16) 18/229 (7.86) 0 5/18 (27.78) ...

Citations

... Based on these premises, it appears that, among the high-risk list of drugs here analysed, trazodone generated indeed the strongest SDR, whilst olanzapine and tadalafil seemed somewhat more prone to cause priapism vs. the other drugs of the database (except for trazodone). The propensity of trazodone to elicit priapism is already well documented in the literature [19][20][21]. Although a number of medications identified in this list may be prescribed by sexual medicine specialists, most of these drugs are typically prescribed by psychiatrists and primary care doctors. ...
... Although a number of medications identified in this list may be prescribed by sexual medicine specialists, most of these drugs are typically prescribed by psychiatrists and primary care doctors. It is of outmost importance that physicians prescribing trazodone are aware and prepared to face this possible detrimental side effect [20], as this medication is still prescribed to more than 27 million Americans [17]. To this respect, some 229 male patients younger than 50 years taking trazodone were surveyed regarding their pretreatment counselling: only less than 20% of the patients were informed about the possible risk of prolonged erections and priapism [20]. ...
... It is of outmost importance that physicians prescribing trazodone are aware and prepared to face this possible detrimental side effect [20], as this medication is still prescribed to more than 27 million Americans [17]. To this respect, some 229 male patients younger than 50 years taking trazodone were surveyed regarding their pretreatment counselling: only less than 20% of the patients were informed about the possible risk of prolonged erections and priapism [20]. The concomitant use/abuse of other legal and/or illegal drugs known to cause priapism may increase the risk of trazodone-induced priapism, due to a synergistic effect [6]. ...
Article
Full-text available
A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a) which medications are associated with most priapism-reports; and, b) within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to identify those drugs associated the most with priapism reports over the last 5 years. Only those drugs being associated with a minimum of 30 priapism reports were considered. The Proportional Reporting Ratios (PRRs), and their 95% confidence intervals were computed. Out of the whole 2015–2020 database, 1233 priapism reports were identified, 933 of which (75.7%) were associated with 11 medications with a minimum of 30 priapism-reports each. Trazodone, olanzapine and tadalafil showed levels of disproportionate reporting, with a PRR of 9.04 (CI95%: 7.73–10.58), 1.55 (CI95%: 1.27–1.89), and 1.42 (CI95%: 1.10–1.43), respectively. Most (57.5%) of the reports associated with the phosphodiesterase type 5 inhibitors (PDE5Is) were related with concomitant priapism-eliciting drugs taken at the same time and/or inappropriate intake/excessive dosage. Patients taking trazodone and/or antipsychotics need to be aware of the priapism-risk; awareness among prescribers would help in reducing priapism-related detrimental sequelae; PDE5I-intake is not responsible for priapism by itself, when appropriate medical supervision is provided.