Pathophysiology of Prolonged Penile Erection associated with Trazodone Use

Tejada, Iñigo Sáenz de; Ware, J. Catesby; Blanco, Ramon; Pittard, Joe Tom; Nadig, Perry W.; Azadzoi, Kazem M.; Krane, Robert J.; Goldstein, Irwin

doi:10.1016/s0022-5347(17)38247-2

Cited by 106 publications

(43 citation statements)

References 26 publications

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“…38 Saenz de Tejada et al reported on the pathophysiology of prolonged erections associated with trazodone use. 41 Trazodone signi®cantly improved nocturnal penile tumescence. Trazadone displaced NE-induced dose dependent contractile response curve to the right and caused dose dependent relaxation of tissue strips pre-contracted with NE.…”

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 96%

“…Trazodone also reduced the contractile response to electrical ®eld stimulation. 41 These observations suggest that trazodone hydrochloride acts peripherally via a mechanism mimicking alpha blocking properties. 38,40,41 It should be noted that metabolites of trazadone can activate hydroxytryptamine receptors (HT1c) in the spinal cord, and these metabolites are believed to contribute to the erectogenic effect of this drug (reviewed in ref.…”

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 97%

“…83 Trazodone hydrochloride (Desyrel TM ) is an oral serotonergic antidepressant which was noted to improve erectile function in impotent men and cause prolonged erections and priapism in potent men. 40,41 Injection of trazodone intracavenosally in the rabbit penis produced full penile erection in 76±84% of animals. Injection of trazodone into volunteers produced tumescence but not full penile erection.…”

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 99%

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Role of alpha adrenergic receptors in erectile function

et al. 2000

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Penile erection is a complex physiological process in which the regulation of penile hemodynamics depends on signal input from central and peripheral nervous systems, and on the balance and interplay between several local physiological mediators (neurotransmitters, vasoactive agents and endocrine factors). A role for the sympathetic nervous system in attaining or maintaining penile¯accidity and detumescence is well recognized. However, the exact mechanisms of alpha-adrenergic receptor mediated erectile function remain poorly de®ned. The objective of this review is to summarize data presented in the literature and from our laboratory on alpha-adrenergic receptors, and to discuss the conceptual framework by which the alphaadrenergic receptor pathway modulates penile corpus cavernosum smooth muscle contractility. We will integrate the current state of knowledge of penile erection into one framework encompassing the biochemical and physiological pathways responsible for trabecular smooth muscle relaxation (erection) and contraction (detumescence). We will focus our discussion on local control mechanisms of alpha-adrenergic receptors and explore the following topics: (1) functional activity of alpha-1 and alpha-2 adrenergic receptors in the physiology of human penile erection; (2) identi®cation, classi®cation and characterization of alpha-1 and alpha-2 adrenergic receptor subtypes in human penile erectile tissue; (3) molecular mechanism of action of alpha-1 and alpha-2 adrenergic receptors in human penile erectile tissue; (4) blockade of alpha-1 and alpha-2 adrenergic receptor action by selective and non-selective alpha-1 and alpha-2 adrenergic receptor antagonists (blockers); (5) physiologic (functional) antagonism of alpha-1 and alpha-2 adrenergic receptor activity by vasodilators mediating smooth muscle relaxation; and (6) key areas of consensus, as well as critical gaps in the existing scienti®c knowledge concerning the rationale and the potential use of alpha-blockers in erectile function.

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Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 96%

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 97%

Section: Alpha Adrenergic Receptor Blockade In Erectile Dysfunctionmentioning

confidence: 99%

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Role of alpha adrenergic receptors in erectile function

et al. 2000

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“…27,28 It has been shown to increase nocturnal penile tumescence episodes when administered orally and induce tumescence when injected intracorporeally. 27,28 A recent clinical trial demonstrated limited ef®cacy in patients with psychogenic and mild organic ED. 29 Synergistic effects with yohimbine have also been reported.…”

Section: Oral Therapymentioning

confidence: 99%

Medical and surgical advances in the radical prostatectomy patient

Nehra

2000

Int J Impot Res

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Maintaining the quality of life after surgery in the radical prostatectomy patient is of paramount importance. One of the major dilemmas in surgical management of radical retropubic prostatectomy (RRP) is preservation of the neurovascular bundle and, hence, erectile function and the continence mechanism. This manuscript addresses anatomical considerations for the surgeon and discusses the following issues with regard to medical and surgical therapies: (1) incidence of erectile dysfunction solely due to complications during RRP; (2) nerve damage during RRP; (3) vascular damage during RRP; (4) current medical and surgical therapies for restoring or maintaining potency; and (5) new advances on the horizon for management of the prostatectomy patient.

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“…It has been tested in animals and in vitro on human cavernous tissue. 7,8 Its ability to induce erections has been shown by injecting it intracavernously in humans. 9 Nocturnal erections are prolonged by trazodone.…”

Section: Introductionmentioning

confidence: 99%

Trazodone, a double blind trial for treatment of erectile dysfunction

Meinhardt

Schmitz²,

Kropman

et al. 1997

Int J Impot Res

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Objective: to assess the effectiveness of oral trazodone 150 mg/d for treatment of erectile dysfunction. Patients and methods: a double-blind, placebo controlled, multicentre trial. A run-in period of two weeks was followed by four weeks of medication. Evaluation was done by patients diary, a questionnaire and Rigiscan TM nightly penile tumescence and rigidity (NPTR) measurements in the second and sixth week of the trial. Results: 69 patients were randomised, two patients never returned for follow-up, nine patients stopped the medication due to side-effects, so 58 patients are evaluable for effect assessment. Half of the patients suffered psychogenic impotence. There was no signi®cant difference in the subjective results of trazodone compared to placebo. Side effects occurred more often with the use of trazodone, but this was not statistically signi®cant. Conclusion: In a group of patients, that was not selected on the basis of the etiology of the erectile dysfunction, nor selected on the duration of the complaint, the ef®cacy of trazodone 150 mg/d, could not be shown.

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Pathophysiology of Prolonged Penile Erection associated with Trazodone Use

Cited by 106 publications

References 26 publications

Role of alpha adrenergic receptors in erectile function

Role of alpha adrenergic receptors in erectile function

Medical and surgical advances in the radical prostatectomy patient

Trazodone, a double blind trial for treatment of erectile dysfunction

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