Priapismo por trazodona

Gómez, Miguel Ángel Sánchez; Martín, J.A. Portillo; García, B. Martín; Rodríguez, Rafael Hernández; Baños, J.L. Gutiérrez; Schaan, J.I. Del Valle; Edreira, A. Roca; Velázquez, Miguel Ángel Rado; Castrillo, A. Hernández

doi:10.1016/s0210-4806(00)72559-9

Cited by 8 publications

(3 citation statements)

References 9 publications

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“…Rare cases of priapism have also been reported in men treated with trazodone. 36,37 Additionally, trazodone should be avoided in men who have specific hematologic or neurologic diseases (such as sickle cell anemia, multiple myeloma, leukemia, hypercoagulable states, or autonomic nervous system disorders) or in men with anatomical deformations of the penis. 38 Propranolol, 50 mg/d for 8 days, is the intervention that contributes the most to the heterogeneity of our main random-effects model due to the inclusion of trials lasting 2 days or less.…”

Section: Discussionmentioning

confidence: 99%

“…A limitation to its use is the absence of marketing authorization in some European countries, including France and Denmark. Rare cases of priapism have also been reported in men treated with trazodone . Additionally, trazodone should be avoided in men who have specific hematologic or neurologic diseases (such as sickle cell anemia, multiple myeloma, leukemia, hypercoagulable states, or autonomic nervous system disorders) or in men with anatomical deformations of the penis …”

Section: Discussionmentioning

confidence: 99%

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Drug Efficacy in the Treatment of Antipsychotic-Induced Akathisia

Gerolymos,

Barazer,

Yon

et al. 2024

JAMA Netw Open

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ImportanceAntipsychotic-induced akathisia (AIA) occurs in 14% to 35% of patients treated with antipsychotics and is associated with increased suicide and decreased adherence in patients with schizophrenia. However, no comprehensive review and network meta-analysis has been conducted to compare the efficacy of treatments for AIA.ObjectiveTo compare the efficacy associated with AIA treatments.Data SourcesThree databases (MEDLINE, Web of Science, and Google Scholar) were systematically searched by multiple researchers for double-blind randomized clinical trials (RCTs) comparing active drugs for the treatment of AIA with placebo or another treatment between May 30 and June 18, 2023.Study SelectionSelected studies were RCTs that compared adjunctive drugs for AIA vs placebo or adjunctive treatment in patients treated with antipsychotics fulfilling the criteria for akathisia, RCTs with sample size of 10 patients or more, only trials in which no additional drugs were administered during the study, and RCTs that used a validated akathisia score. Trials with missing data for the main outcome (akathisia score at the end points) were excluded.Data Extraction and SynthesisData extraction and synthesis were performed, estimating standardized mean differences (SMDs) through pairwise and network meta-analysis with a random-effects model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed.Main Outcomes and MeasuresThe primary outcome was the severity of akathisia measured by a validated scale at the last available end point.ResultsFifteen trials involving 492 participants compared 10 treatments with placebo. Mirtazapine (15 mg/d for ≥5 days; SMD, −1.20; 95% CI, −1.83 to −0.58), biperiden (6 mg/d for ≥14 days; SMD, −1.01; 95% CI, −1.69 to −0.34), vitamin B6 (600-1200 mg/d for ≥5 days; SMD, −0.92; 95% CI, −1.57 to −0.26), trazodone (50 mg/d for ≥5 days; SMD, −0.84; 95% CI, −1.54 to −0.14), mianserin (15 mg/d for ≥5 days; SMD, −0.81; 95% CI, −1.44 to −0.19), and propranolol (20 mg/d for ≥6 days; SMD, −0.78; 95% CI, −1.35 to −0.22) were associated with greater efficacy than placebo, with low to moderate heterogeneity (I2 = 34.6%; 95% CI, 0.0%-71.1%). Cyproheptadine, clonazepam, zolmitriptan, and valproate did not yield significant effects. Eight trials were rated as having low risk of bias; 2, moderate risk; and 5, high risk. Sensitivity analyses generally confirmed the results for all drugs except for cyproheptadine and propranolol. No association between effect sizes and psychotic severity was found.Conclusions and RelevanceIn this systematic review and network meta-analysis, mirtazapine, biperiden, and vitamin B6 were associated with the greatest efficacy for AIA, with vitamin B6 having the best efficacy and tolerance profile. Trazodone, mianserin, and propranolol appeared as effective alternatives with slightly less favorable efficacy and tolerance profiles. These findings should assist prescribers in selecting an appropriate medication for treating AIA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Drug Efficacy in the Treatment of Antipsychotic-Induced Akathisia

Gerolymos,

Barazer,

Yon

et al. 2024

JAMA Netw Open

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“…The anticholinergic side effects, particularly dry mouth, blurred vision, constipation, and urinary retention are rare, as they are those due to α-adrenoreceptor blockade, such as hypotension and sedation. Interestingly, trazodone treatment has been seldom associated with priapism,10,11 a characteristic that can be used to revert the sexual dysfunctions provoked by other psychotropic drugs 12…”

Section: Introductionmentioning

confidence: 99%

Trazodone effects on [3H]-paroxetine and α2-adrenoreceptors in platelets of patients with major depression

Marazziti

Consoli²,

Golia³

et al. 2010

NDT

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Trazodone is an antidepressant which behaves as a selective 5-HT2 antagonist and 5-HT reuptake inhibitor. The lack of information on its effects in vivo prompted us to evaluate α2-adrenoceptors by means of the specific binding of [3H]-rauwolscine, and the 5-HT transporter (SERT) by means of the binding of [3H]-paroxetine ([3H]-Par), in platelets of depressed patients, before and after one month of treatment with trazodone (75–300 mg/day). Twenty-five outpatients of both sexes with a diagnosis of major depression, as assessed by the Structured Clinical Interview for DSM IV, were included in the study. Depressive symptoms were evaluated by means of the Hamilton Rating Scale for Depression: the total score (mean ± SD) was 20 ± 6 at baseline (t0) and 7 ± 4 after one month of treatment (t1). Platelet membranes, [3H]- rauwolscine and [3H]-Par bindings were carried out according to standardized protocols. The results showed that the Bmax values of [3H]-Par were statistically lower at t1 than at t0 (733 ± 30 vs 1471 ± 99, P < 0.001), while the Kd and the [3H]-rauwolscine binding parameters remained unchanged. The findings of this study suggest that in vivo trazodone modifies the number of the SERT proteins and that, perhaps, most of its antidepressant properties are related to this activity.

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