From the Guidelines
The probability of developing priapism while taking Trazodone is approximately 6.8%.
Trazodone Side Effects
- The study 1 reported that out of 74 male patients taking Trazodone, 5 subjects developed priapism, which is a significant side effect.
- The mean effective dose of Trazodone in this study was 212 mg/day, and 60% of patients who continued treatment experienced some side effect.
- Priapism was the reason for discontinuation of treatment in 5 out of 14 patients who stopped taking Trazodone due to intolerable side effects.
Context and Generalizability
- This study was conducted in a specialized inpatient unit for the treatment of PTSD, and the results may not be generalizable to all patients taking Trazodone.
- However, the study provides valuable information on the potential side effects of Trazodone, including priapism, which is a rare but serious condition.
- The risk of priapism should be carefully considered when prescribing Trazodone, especially in patients with a history of erectile dysfunction or other risk factors for priapism.
From the Research
Probability of Developing Priapism
The probability of developing priapism while taking Trazodone is not explicitly stated in the provided studies. However, the studies suggest that priapism is a rare but serious side effect of Trazodone.
Incidence of Priapism
- A study published in 2021 2 found that 18 out of 229 patients (7.8%) developed prolonged erections while taking Trazodone.
- A case series published in 2019 3 reported 19 cases of priapism likely caused by various psychotropics, including Trazodone.
- A study published in 1987 4 reviewed data reported to the Food and Drug Administration and found that priapism may be most likely to occur within the first 28 days of treatment with Trazodone.
Risk Factors
- The studies suggest that priapism can occur at nearly any age and with any dose of Trazodone 3.
- A study published in 1991 5 found that Trazodone can enhance penile erection in men and propose a mechanism related to the alpha-adrenoceptor blocking properties of Trazodone.
- A case report published in 2005 6 presented a patient who developed priapism after taking a single 100-mg dose of Trazodone.
Screening and Counseling
- A study published in 2021 2 found that only a fraction of patients were properly screened for previous prolonged erections or priapism and properly informed about the side effects of Trazodone.
- The study suggests that urologists should better educate Trazodone prescribers about the side effects of Trazodone and that prescribing physicians should appropriately screen and educate patients prior to Trazodone initiation 2.