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Increased libido in women receiving trazodone
Abstract
The author presents the cases of three depressed women whose libido increased to above premorbid levels during trazodone treatment. Two patients resisted discontinuing the drug because of this pleasurable side effect.
... Існує також публікація про підвищення сексуального потягу у жінок, які страждають на депресію і отримують тразадон. Так, N. Gartrell [22] повідомляє про трьох жінок, які страждають на депресію, чиє лібідо при лікуванні тразадоном у дозі до 150 мг на день посилилося вище преморбідних рівнів. В однієї з цих пацієнток, якій було 26 років, зафіксовано ангедонію, гіперсомнію, надмірне почуття провини та суїцидальні думки. ...
Currently, there are a huge number of drugs. Every year their number increases and their number is in the tens of thousands, which makes it possible to speak of a “pharmaceutical explosion”. In addition to its main therapeutic effect, each of the drugs has side effects, which, in particular, may affect the sexual sphere. This article discusses the literature on the side effects of psychotropic drugs and anticonvulsants, which can lead to hypoactive sexual desire and other sexual dysfunctions. The side effects on sexual functions of tranquilizers, antipsychotics (traditional and newer), antidepressants of various groups (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, as well as newer antidepressants), mood stabilizers and anticonvulsants are considered. The degree of influence of neuroleptics and antidepressants on sexual function is discussed depending on the dose, duration of administration, belonging to one or another chemical class. It is noted that some drugs from these groups can have a stronger negative effect on sexual functions, others have a moderate or weak effect, and still others not only do not have such an effect, but even increase sexual desire and other sexual functions. Therefore, before starting to take one or another drug from these groups, one should evaluate the state of sexual functions and, in case of their violation, prescribe such drugs that have the same therapeutic effect, but when they are used, there is no risk of adverse effects on the sexual sphere. These drugs (for example, antidepressants) should be prescribed as a substitute even in cases where a drug with an antidepressant effect was previously taken, which led to sexual dysfunctions.
... It also causes a condition known as priapism which is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended so it was also tried for treatment of ED [64]. Another added value for TZD was reported as it's capable of increasing sexual libido in both men and women [65,66]. ...
This literature review focuses on drugs used for erectile dysfunction and premature ejaculation, in respect of mode of action and different analytical techniques used for their determination either alone or in combination with other drugs in different pharmaceutical and biological matrices. The cited drugs are Sildenafil, Avanafil, Apomormphine, Yohimbine, Tramadol, Dapoxetine, and Trazodone.
... Высокая приверженность пациентов терапии тразодоном во многом обусловлена отсутствием способности ухудшать сексуальные функции. Напротив, тразодон способен усиливать либидо (как у мужчин, так и у женщин) и даже, в ряде случаев, вызывать приапизм; впрочем, частота данного побочного эффекта не превышает 0,01% [13][14][15][16][17]. В отличие от ряда антидепрессантов, тразодон не вызывает и не усиливает двигательные расстройства, в частности синдром беспокойных ног и периодические движения конечностей [18]. ...
The efficacy of modern antidepressants is largely related to their ability to enhance neurotransmission of serotonin. The medicines with serotonergic properties include trazodone, which is intermediate between tricyclic antidepressants with their powerful antidepressive effect and selective serotonin reuptake inhibitors, as first-line agents in the treatment of depression and anxiety disorders. The value of trazodone for clinical practice is determined by the effective elimination of the symptoms of major depressive disorder in combination with good tolerability, including in elderly patients. Among the advantages of trazodone is the absence of such undesirable effects as sexual dysfunction and weight gain. Trazodone has significant hypnotic and anxiolytic properties, which gives it special meaning in the treatment of depression, combined with insomnia and anxiety. It is emphasized that the beneficial effect of trazodone on sleep should not prevent its main use as a drug for treating major depressive disorder regardless of whether depression is accompanied by insomnia or not.
Em pesquisa bastante ampla procuramos fazer uma revisão da literatura o mais completa possível. Embora a quantidade de trabalhos publicados seja muito grande, admitimos que haja um déficit considerável, visto que a maioria das pesquisas se resume em apresentação de casos isolados ou em pequenas séries. Considerável quantidade de trabalhos é em aberto e alguns poucos são placebo-controlados aleatórios com a comparação duplo-cego. Fizemos um estudo da função sexual e seu envolvimento com o uso dos antidepressivos, da fisiopatologia envolvida e da conduta para tentar resolver o problema. Foram feitas também considerações sobre os vários antí- dotos usados no tratamento e sobre alternativas terapêuticas. Concluímos que, apesar dos inúmeros trabalhos publicados, há necessidade de mais pesquisas com trabalhos placebo-controlados duplo-cego aleatório e com o uso rigoroso de escalas padronizadas que investiguem os parâmetros depressivos e as alterações da função sexual relacionada com o uso dos antidepressivos.
Farmakolojik ajanlar ile cinsel fonksiyonlar arasındaki ilişki Antik çağlardan bu yana merak konusu olmuştur. Yüzyıllar boyunca asıl odak konusu kişinin cinselliğe odaklanmasını veya arzusunu arttırmaya yönelik olan kimyasal maddelere olmuştur. Bu maddelerden
ilerleyen bölümlerde bahsedeceğiz. Son yıllarda ilaç endüstrisinin gelişmesi, karmaşık farmasötik ajanlar ile cinsel işlev üzerine etkileri merak edilen bir konu haline getirmiştir.
İlaçların, cinsel fonksiyonun tamamını ya da hangi aşamasını etkilediğini ayırt etmek
oldukça zordur. Genellikle bir ya da birkaç aşama üzerinde etkili olmaktadırlar. Cinsel İşlev
Bozukluğu (CİB)’na neden olan ilaçlar yaşam kalitesini olumsuz etkilemesinin yanında, ilaç
tedavisine uyumu da azaltmaktadır.
Medication and device development for women's sexual health has lagged significantly behind both scientific advances and comparable innovations in men's sexual health. Testosterone therapy for hypogonadism is just one example. As such, women are forced to use male products at scaled down doses, or compounded products with their variabilities of formulation and absorption, and without the benefit of a package insert outlining any risks. While proprietary and confidentiality restrictions limit some of the thrilling developments reviewed here, the innovative landscape remains exciting. Future developments will, ultimately, depend upon the market and financial success of currently approved therapies.
Trazodone is a new antidepressant agent that was recently introduced in the United States. It has a unique pharmacological profile that is not typical of either tricyclic or monoamine oxidase inhibitor antidepressants. As such it represents a new class of antidepressant drugs. The efficacy of trazodone has been clearly established in comparative studies with imipramine and amitriptyline. Major depression is the principal indication for its use, but good results have been shown in a wide variety of depressive subtypes. Of particular importance is the low frequency of adverse reactions seen with this drug.
In double-blind studies-one of endogenous and one of neurotic depressed patients-trazodone produced fewer anticholinergic side effects than either of the two reference tricyclic antidepressants (imipramine and amitriptyline). Trazodone also had a significantly lower incidence of neurological effects than imipramine. Of those who discontinued imipramine therapy, 50% dropped out because of either anticholinergic or neurological effects. These differences between trazodone and the tricyclic agents are important in planning the treatment of depressed patients, particularly the elderly in whom anticholinergic and neurological problems can be hazardous. Although trazodone's sedative effects are comparable to those of the tricyclic antidepressants, its favorable side effect profile and demonstrated effectiveness may make trazodone the drug of choice in the pharmacotherapy of depression.