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Trazadone ed: Trazodone for erectile dysfunction: a systematic review and meta-analysis

Trazodone for erectile dysfunction: a systematic review and meta-analysis

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Review

. 2003 Sep;92(4):441-6.

doi: 10.1046/j.1464-410x.2003.04358.x.

H A Fink 
1
, R MacDonald, I R Rutks, T J Wilt

Affiliations

Affiliation

  • 1 Geriatric Research Education and Clinical Center, Section of General Internal Medicine, VA Medical Center, Minneapolis, USA. [email protected]
  • PMID:

    12930437

  • DOI:

    10.1046/j.1464-410x.2003.04358.x

Review

H A Fink et al.

BJU Int.

2003 Sep.

. 2003 Sep;92(4):441-6.

doi: 10. 1046/j.1464-410x.2003.04358.x.

Authors

H A Fink 
1
, R MacDonald, I R Rutks, T J Wilt

Affiliation

  • 1 Geriatric Research Education and Clinical Center, Section of General Internal Medicine, VA Medical Center, Minneapolis, USA. [email protected]
  • PMID:

    12930437

  • DOI:

    10.1046/j.1464-410x.2003.04358.x

Abstract


Objective:

To determine the efficacy and safety of trazodone in the treatment of erectile dysfunction (ED) in a meta-analysis.


Methods:

The data sources used were Medline and the Cochrane Library databases (January 1966 to May 2002), bibliographies of retrieved articles and review articles, and conference proceedings and abstracts. Trials were eligible for inclusion in the review if they included men with ED, compared trazodone with a control, were randomized, of > or = 7 days’ duration and assessed clinically relevant outcomes. Two reviewers independently evaluated study quality and extracted data in a standardized fashion.


Results:

Six trials (comprising 396 men) met the inclusion criteria; they consisted of heterogeneous populations, were small, brief and in some cases methodologically weak. Three of the six trials showed an apparently clinically meaningful benefit of trazodone for ED compared with placebo, the differences being statistically significant in two. In pooled results, trazodone monotherapy appeared more likely than placebo to lead to a ‘positive treatment response’, although this difference was not statistically significant (37% vs 20%; relative benefit increase, 1.6; 95% confidence interval, CI, 0.8-3.3). Subgroup analyses suggested that men with psychogenic ED might be more likely to benefit from trazodone than those with mixed or physiological ED. The efficacy of trazodone also appeared greater at higher doses (150-200 vs 50 mg/day). Men randomized to trazodone were not significantly more likely than those receiving placebo to withdraw for any reason or for an adverse event, or to have specific adverse events, but wide CIs could not exclude a greater risk of these adverse outcomes with trazodone. Specific adverse events with trazodone included dry mouth (19%), sedation (16%), dizziness (16%) and fatigue (15%).


Conclusion:

Trazodone may be helpful in men with ED, possibly more so at higher doses, and in men with psychogenic ED. Future high-quality trials should compare trazodone with placebo and other therapies in men with depression and psychogenic ED.

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Oral trazodone as empirical therapy for erectile dysfunction: a retrospective review

. 1995 Jul;46(1):117-20.

doi: 10.1016/S0090-4295(99)80176-9.

R Lance 
1
, M Albo, R A Costabile, W D Steers

Affiliations

Affiliation

  • 1 Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
  • PMID:

    7604472

  • DOI:

    10.1016/S0090-4295(99)80176-9

R Lance et al.

Urology.

1995 Jul.

. 1995 Jul;46(1):117-20.

doi: 10.1016/S0090-4295(99)80176-9.

Authors

R Lance 
1
, M Albo, R A Costabile, W D Steers

Affiliation

  • 1 Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
  • PMID:

    7604472

  • DOI:

    10.1016/S0090-4295(99)80176-9

Abstract


Objectives:

Anecdotal reports of increased libido and sexual function in patients taking trazodone have led to its empirical use in patients with erectile dysfunction. A retrospective review of patient-reported responses to trazodone was performed to outline the efficacy and side-effect profile of this agent.


Methods:

Between 1989 and 1994, 182 patients were placed on oral trazodone as empirical therapy for erectile dysfunction. Patients ranged in age from 26 to 85 years, with a mean of 60 years. Patients were evaluated before receiving trazodone with a thorough medical history and physical examination. Known risk factors for erectile dysfunction were assigned based on historical information and the findings of the examination. Patients received trazodone for at least 2 consecutive months, with daily doses starting at 25 mg.


Results:

One hundred twenty-seven patients were available for follow-up by a standardized questionnaire regarding perceived improvement in erectile function, sexual function, and side effects. In patients less than 60 years of age, with no known risk factors for erectile dysfunction, 21 of 27 (78%) showed significant improvement in erectile ability. Smokers and patients older than 60 years with a history of significant peripheral vascular disease responded poorly to trazodone therapy. The duration of erectile dysfunction was inversely related to a response to trazodone. Of patients with a duration of impotence less than 12 months, 48% reported a positive response. Only 16% of patients with duration of erectile dysfunction greater than 60 months reported improvement in erections and sexual function. Trazodone was well tolerated by this population, with 62% reporting no side effects.


Conclusions:

Despite the limitations of a nonrandomized, retrospective study, trazodone appears to benefit younger patients with erectile dysfunction with few known risk factors. A prospective, placebo-controlled trial is needed to confirm the observations of this pilot study.

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Treatment of erectile dysfunction and lower urinary tract syndrome in Butovo in the high-tech clinic “LazerVita”

Modern approach to the treatment of erectile dysfunction and lower urinary tract syndrome caused by stressful conditions

Gnoyan Sergey Vasilievich urologist andrologist

During the year, 23 patients came to our clinic with complaints of a decrease in copulative function that occurred after a stressful state. The age of the patients ranged from 31 to 56 years. 14 (60.9%) of patients over 40 years of age had lower urinary tract syndrome (dissatisfaction with urination). Initially, the patients were prescribed DNA PCR analysis for 15 STIs, microscopic analysis of pancreatic secretion. According to preliminary analyzes: Ureaplasma urealyticum + Gardnerella vaginalis was detected in 10 (43.5%) patients. In the analysis of the secretion of the pancreas, leukocytes are 50-70 in the field of view, there are no chimney grains. In 5 (21.7%) patients, the following were detected: Chlamidia trachomatis + Candida albicans. In the analysis of the secret of the pancreas, leukocytes 30-50 in the field of view, lecithin grains – an insufficient amount. In the remaining 8 (34.8%) patients, no pathology was detected in the preliminary tests.

Two groups of patients diagnosed with STIs were previously given a course of antibiotic therapy with a fluoroquinolone drug levofloxacin (Eleflox) 500 mg intravenously in combination with the immunomodulator geneferon in suppositories 1 million IU, 1 suppository at night for 10 days. Then, all patients were prescribed a comprehensive program of drug and physiotherapy treatment. During the treatment, Tada-lafil (Cialis) 5 mg daily for 28 days, trazodone (trittiko) 75 mg daily for 28 days, sperm-strong (BAA) 1 capsule daily 2 times a day for 28 days were prescribed. The entire group of patients underwent a course of treatment with local negative pressure (LOP-therapy) using the AMVL-01 “Yarovit” device with a daily selection of an individual treatment program. Also, all patients underwent a 10-day course of laser therapy with the Mustang-2000 apparatus. Rectal and surface sensors were used simultaneously.

At the end of the course of LOD-therapy and laser therapy, a 10-day course of intravenous ozone therapy was carried out in combination with intravenous laser blood irradiation. Against the background of the entire course of therapy every other day, patients underwent pancreatic massage and intramuscular administration of the drug prostatilen. At the end of the treatment, 20 (87%) patients did not show any complaints. Two (9%) patients felt insecure before sexual intercourse. They continued maintenance therapy with tada-lafil (Cialis) 5 mg + trazodone (Trittico) 75 mg for another 28 days. During the next calendar year, this group of patients did not complain. Thus, this complex treatment allows patients to avoid recurrence of the disease for a long time.

The article was published in the collection of abstracts of the First Russian-Asian Congress, held in St. Petersburg from May 24 to May 26, 2014.

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