Side effects of trazodone – NHS

Like all medicines, trazodone can cause side effects in some people, but many people have no side effects or only minor ones.

Common side effects

Some of the common side effects of trazodone will gradually get better as your body gets used to it. There are things you can do to help cope with them:

Feeling sleepy or tired

Take trazodone in the evening and try to cut down the amount of alcohol you drink. If you take trazodone twice a day, talk to your doctor. Feeling sleepy should become less of a problem after a few days as your body gets used to the medicine. Do not drive, ride a bike or use tools or machinery if you’re feeling sleepy or tired.

Headaches

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.

Feeling sick (nausea)

Try taking trazodone with or after food to see if that helps. It’s best to avoid rich or spicy food while you’re taking this medicine.

Constipation

Eat more high-fibre foods, such as fresh fruit and vegetables and cereals. Try to drink several glasses of water every day. If you can, it may also help to do some exercise.

A dry mouth

Try sugar-free gum or sugar-free sweets.

Tell your doctor if this advice does not help or the side effects do not go away.

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call your doctor or contact 111 now if:

• the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
• you have difficulty pooing (constipation) or you’re unable to pee
• you are bruising more easily than usual or have unexplained bruising
• you get more infections than usual, such as a sore throat or skin infections
• you have a fast, slow or abnormal heartbeat

Go to 111. nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E now if you have:

• a long-lasting and painful erection that lasts longer than 2 hours – this may happen even when you’re not having sex
• a seizure or fit
• thoughts of self-harming or ending your life

Find your nearest A&E

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to trazodone.

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Sexual side effects

Trazodone can cause problems with ejaculation. Some people say it gives them a higher sex drive, others say it makes it lower.

Other side effects

These are not all the side effects of trazodone. For a full list, see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 9 March 2022

Next review due: 9 March 2025

Trazodone: Side Effects, Withdrawal, & Treatment

Causes of Depression

Sometimes, it is used as an off-label treatment for other conditions, such as insomnia, schizophrenia, and anxiety.

Trazodone belongs to a class of medications called serotonin modulators, which means they work by altering the activity of post-synaptic serotonin receptors and by inhibiting the reuptake of serotonin.

While trazodone is not considered a highly addictive prescription medication, it still has a potential for misuse and dependence.

Individuals who abuse trazodone or who are prescribed it should be aware of its effects and seek professional advice.

What Is Trazodone Mainly Used For?

Trazodone is mainly used to treat depression.

However, it is also sometimes used to treat anxiety, insomnia, and schizophrenia.

What Is The Brand Name For Trazodone?

Brand names for trazodone include:

• Desyrel
• Oleptro
• Trialodine

Is Trazodone Addictive For People?

Trazodone is not considered highly addictive, yet there is still potential for misuse and dependence.

A study done by Psychopharmacology discussed the abuse potential for three different drugs, including trazodone, Ambien, and Halcion.

Findings suggest that trazodone is less addictive than the other two drugs in the study, yet it is still misused and can cause physical dependence, especially when used for a long period.

According to Substance Abuse and Rehabilitation, most cases of antidepressant abuse occur in individuals with other substance use and mood disorders.

What Class Of Drug Is Trazodone?

Trazodone is a serotonin modulator, or in the serotonin-antagonist-and-reuptake-inhibitor (SARI) class of medications.

Serotonin is a neurotransmitter that plays an important function in mood stabilization. When a person’s serotonin levels are low, it can contribute to depression and other mental health disorders.

Serotonin modulators, like trazodone, work by targeting certain serotonin receptors, including the 5-HT2A receptor.

What Does Trazodone Look Like?

Trazodone is usually white and round or oval-shaped.

It also has scores imprinted on the sides that may be used to break the tablet in half to split the medication into two doses if recommended by your doctor.

Trazodone Uses

How Do You Take Trazodone?

Trazodone comes as a tablet that should be taken by mouth.

It is usually recommended to take trazodone with a meal or snack two or more times a day.

The tablets are either taken whole or broken in half where indented and taken.

If prescribed, it is important to follow your doctor’s orders carefully, along with any directions on your prescription label. A person should not take more or less than what is prescribed without consulting with their doctor.

How Does Trazodone Make You Feel?

Most people who have been prescribed trazodone report feelings of relaxation and sleepiness.

It can also help people improve their mood and manage the symptoms of depression.

Some people may abuse trazodone for its sedative effects and to achieve a “high.” While it may not produce a sense of euphoria similar to other drugs like marijuana, it can make a person feel extremely relaxed and drowsy, and some people find pleasure in it.

Additionally, when first taking trazodone, a person may feel that their symptoms of depression or anxiety are worsening.

This can be because the body is adjusting to new chemical levels and changes. However, it is important to let your doctor know if you are experiencing adverse side effects.

Is Trazodone Habit-Forming?

Trazodone is not known to be habit-forming. However, it should only be taken as prescribed to avoid misuse and potentially dangerous adverse effects.

Is Trazodone Good To Take Every Night?

It is not uncommon for trazodone to be prescribed daily and to be taken in the evening.

However, if a person is misusing trazodone, taking it every night can be extremely harmful, increase the risk of overdose, and have serious negative effects on their physical and mental health.

How Long Does It Take For Trazodone To Work?

It can take a couple of weeks for trazodone to start to work and for a person to see improvements.

It can take the body time to adjust to the medication. For some people, trazodone can take up to 6 weeks to work.

Can You Take Trazodone For Sleep And Anxiety?

Trazodone is sometimes used as an off-label treatment for sleep and anxiety.

Who Should Avoid Trazodone?

It is always important to let your healthcare provider know any current medications or supplements you are taking, along with any medical history or conditions you may have before starting trazodone.

If you are planning to become pregnant, are pregnant, or are breastfeeding, consult with your healthcare provider about the safety of taking trazodone.

Trazodone also contains a boxed warning of an increased risk of suicidal thoughts and behaviors in pediatric patients.

It should also be used carefully with elderly individuals as it may increase the risk of hyponatremia, which refers to a low sodium level in the blood.

Additionally, individuals with kidney failure or liver failure should use trazodone with caution and talk to their doctors about risks and safety.

Trazodone Dosage & Interactions

What Is The Typical Dosage Of Trazodone?

When used for depression, the typical dosage of trazodone is 150 mg.

Dosages for trazodone can range from a low dose of 50 mg to 600 mg for hospitalized patients.

Dosages typically start at 150 mg and may be increased in 50 mg increments depending on the individual’s response to the medication.

How Often Should You Take Trazodone?

Trazodone is usually taken as a single dose per day.

Sometimes, a doctor may recommend a person split it in half and take it twice a day.

You should only take trazodone as it is prescribed to you, no more and no less, and if you plan on making any changes to your medication or plan on stopping use, consult with your doctor first.

Is 50mg Of Trazodone A Lot?

50 mg of trazodone is not considered a lot; it is usually the starting dose.

Trazodone is available in 25 mg, 50 mg, 100 mg, and 300 mg oral tablets.

However, taking any dose of a medication when it is not prescribed can be very dangerous and result in harm to both the brain and body.

Can Trazodone Be Mixed With Alcohol?

Alcohol can worsen the effects of trazodone, and mixing the two can become dangerous.

Mixing alcohol with antidepressants like trazodone can not only make a person extremely drowsy but also make a person feel more depressed or anxious.

Individuals who misuse trazodone often do so by combining it with other substances. Mixing substances like trazodone and alcohol can increase a person’s risk of overdose and result in serious consequences.

Are There Interactions Between Lexapro And Trazodone?

Lexapro, or escitalopram, is another antidepressant medication used to treat depression and generalized anxiety disorder.

Taking escitalopram together with trazodone is usually not advised as it may cause adverse side effects and put a person at higher risk of serotonin syndrome.

It is important to let your doctor know if you are already taking Lexapro or any other antidepressants so that you can reduce the risk of negative and potentially dangerous side effects.

What Should You Not Take With Trazodone?

It is important to let your doctor know of any prescription medications and non-prescription medications you are taking, including vitamins and herbal supplements, before starting trazodone.

Herbal products and nutritional supplements that are especially important to mention include St. John’s Wort and tryptophan.

You should let your healthcare provider know if you are taking monoamine oxidase inhibitors (MAOIs) like tranylcypromine or isocarboxazid, as your doctor may typically recommend not taking the medications together.

Taking MAO inhibitors and trazodone together can greatly affect a person’s serotonin levels and cause a spike in a person’s blood pressure.

Important medications to mention include:

• Blood thinners
• Medications for mental illness
• Selective serotonin reuptake inhibitors
• Tricyclic antidepressants
• Antifungals
• Medications for migraines

A person should also take caution before driving if taking trazodone, as its effects can cause impairment. Don’t drive or operate machinery until you know how this medication affects you and after consulting with a doctor.

Trazodone Side Effects

What Are The Side Effects Of Trazodone?

Side effects of trazodone can include:

• Blurred vision
• Nausea and vomiting
• Diarrhea or constipation
• Changes in appetite
• Weight changes
• Feeling weak or tired
• Nervousness
• Dizziness
• Lightheadedness
• Nightmares
• Muscle pain
• Dry mouth
• Rash
• Stuffy nose
• Red or itchy eyes

Serious side effects of trazodone can include:

• Chest pain
• Changes in heartbeat
• Loss of consciousness
• Fainting
• Fever
• Shortness of breath
• Unusual bleeding or bruising
• Headaches
• Problems thinking or concentration
• Trouble with memory
• Lack of coordination

Antidepressants like trazodone can also increase the risk of a person experiencing suicidal thoughts, especially in adolescents, children, and young adults.

In rare cases, trazodone use can cause serotonin syndrome, a potentially life-threatening condition where a person’s serotonin levels are too high, causing them to experience both mental and physical symptoms.

If you or a loved one are experiencing suicidal thoughts, seek help. Call 911 or the national suicide prevention lifeline at 988. You are not alone, and there is help for you.

Trazodone may also cause a condition called angle-closure glaucoma, where the fluid in the eye causes a severe increase in pressure and can lead to vision loss.

Any individual who uses antidepressants for longer than 8 weeks faces the risk of developing a physical dependence on the drug, meaning that they can face withdrawal symptoms if they suddenly stop using the drug or significantly decrease their use.

What Is The Most Likely Side Effect Of Trazodone?

The most common side effects of trazodone include drowsiness, dizziness, and nausea.

Can Trazodone Worsen Anxiety?

When a person first starts trazodone, they may feel that their depression or anxiety is worse because their body is adjusting to the new change.

Usually, in this case, the person tends to feel better after the first few weeks.

However, adverse effects of trazodone can include anxiety or depression.

Does Trazodone Cause Weight Gain?

Yes, trazodone can cause both changes in appetite and weight.

It can make a person more hungry and cause them to eat more and gain weight.

Is Trazodone Hard On Your Heart?

Trazodone could negatively affect a person’s heart.

It can cause a condition known as QT prolongation, which can involve a fast or irregular heartbeat and other potentially serious symptoms.

However, according to Psychopathology, trazodone has been shown to have little effect on cardiac conduction and had shown to produce less postural hypotension than other antidepressants and actually lowers heart rate.

Additionally, trazodone is not usually recommended for those who have suffered a heart attack at any point in their life.

Does Trazodone Affect Your Thinking?

Trazodone may affect a person’s thinking, concentration, and memory, according to MedlinePlus.

Is Trazodone Harmful Long-term?

Trazodone is commonly taken as a long-term medication.

When used as prescribed, trazodone is considered generally safe. However, when misused, trazodone can harm both the brain and body.

Any person who takes antidepressants long-term, whether prescribed or not, has a risk of developing physical dependence.

In this case, the person should seek help from their doctor so they can safely manage their symptoms and reduce the risk of serious effects.

Trazodone Withdrawal & Treatment

What Mental Illness Does Trazodone Treat?

Trazodone is mostly used to treat depression, specifically major depressive disorder.

Trazodone is also sometimes used as an off-label treatment for anxiety.

Does Trazodone Deplete Dopamine?

Trazodone reduces levels of certain neurotransmitters that are associated with arousal effects, including serotonin, noradrenaline, dopamine, acetylcholine, and histamine.

Can Trazodone Be Stopped Abruptly?

No, trazodone should not be stopped abruptly.

Doing so can trigger withdrawal symptoms and become very dangerous.

Withdrawal symptoms of trazodone can include:

• Dizziness
• Nausea and vomiting
• Irritability
• Headaches
• Trouble concentrating

It is important to always let your healthcare provider know if you plan on stopping taking medication so that they can provide you with safety, advice, and supervision if needed.

Trazodone should be tapered, meaning the daily dose should slowly decrease with the end goal of completely discontinuing the medication to reduce the risk of withdrawal symptoms.

Sandstone Care’s Detox program helps with withdrawal symptoms

How Long Does It Take Trazodone To Wear Off?

Trazodone has a half-life of around 5 to 9 hours.

This means that it can take 5 to 9 hours for your body to eliminate half of the drug.

Can You Get Withdrawal Symptoms From Stopping Trazodone?

Yes, a person may experience withdrawal symptoms from stopping trazodone which may include:

• Anxiety
• Insomnia
• Fatigue
• Flu-like symptoms
• Suicidal thoughts

If you or a loved one are experiencing suicidal thoughts, call 911 or the national suicide prevention lifeline at 988.

If you are experiencing withdrawal symptoms, seek medical help and call your doctor so they can give you professional guidance to help you safely manage withdrawal symptoms.

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Can Trazodone Cause Permanent Damage?

Trazodone can lead to long-term and, in some cases, permanent damage.

For example, a person taking trazodone can develop a condition known as priapism, with is an abnormal erection that can lead to permanent damage.

Aside from being used to treat depression, trazodone is also used to treat insomnia, schizophrenia, and anxiety.

However, when used for reasons other than depression, it is not FDA-approved.

It is not considered a first-line treatment for insomnia, although it can be effective in helping sleep.

The link between trazodone use and psychosis is unknown. However, there have been reports of visual hallucinations as an adverse effect of trazodone.

A visual hallucination involves seeing things that aren’t real, which may include objects, lights, shapes, or people.

Brain zaps can feel like a sudden shock in the head which is caused by anxiety, stress, or medications.

Brain zaps can happen when a person stops or decreases their use of medication, especially antidepressants.

Brain zaps may result as a symptom of withdrawal when stopping antidepressants like trazodone.

Trazodone is not known to be addictive.

However, treating sleep disorders like insomnia with trazodone is off-label use that is not approved by the FDA.

Valium, also known as diazepam, is a benzodiazepine used to treat anxiety, muscle spasms, and seizures.

Some people who have been prescribed Valium for sleep and do not see results may sometimes be prescribed trazodone as an alternative.

Trazodone is more commonly used as a treatment for depression and anxiety, while Valium is typically used for anxiety, alcohol withdrawal, and seizures.

While it doesn’t necessarily change your personality, trazodone may cause changes that affect a person’s mood and behaviors.

Adverse effects of trazodone use involve problems with thinking, concentration, and memory.

Some studies have examined the relationship between trazodone use and the development of dementia. However, it appears that more research is needed to determine whether the two are connected.

Let’s take the next steps together

Trazodone is an antidepressant used to treat depressive disorders. Trazodone has the potential to be misused and may come with serious negative effects. Sandstone Care is here to support teens and young adults with mental health and substance use disorders.

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Use of trazodone (trittico) | News and promotions of the European Medical Center “UMMC-Health”

Erectile dysfunction is a disease characterized by “persistent inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse” (1). It is difficult to overestimate the psychological significance for a man and for family relations of this disease (2).

Until the beginning of the twentieth century, psychogenic erectile dysfunction was considered the main cause of erectile dysfunction. Currently, 80% of patients are diagnosed with organic causes of the disease (3).

The occurrence of erectile dysfunction has a very clear age dependence.

The Massachusetts male aging study showed that 12.4% had erectile dysfunction between the ages of 40 and 49, 29.8% between the ages of 50 and 59, and 29.8% between the ages of 60 and 69. in 46.6% of patients (4). In addition to age, diseases such as diabetes mellitus, vascular heart disease, hypertension, depression are directly related to the occurrence of erectile dysfunction (5).

According to the doctor of medical sciences, president of PAAR Shcheplev PA, erectile dysfunction in 25% of cases is of a purely organic nature (vascular disorders, diabetes mellitus, medications, neurological and endocrine disorders, operations on the pelvic organs), 25% is purely psychogenic and in 50% of cases is the result of several reasons.

Thus, the significance of psychogenic causes in the structure of erectile dysfunction, although it has decreased, remains quite high. Of particular relevance are issues related to the treatment of depression in combination with erectile dysfunction.

Depressed men have a risk of developing erectile dysfunction ranging from 25% for mild depression to 90% for severe depression (6).

The frequency and variety of forms of psychogenic erectile dysfunction (7) in the practice of an andrologist determines the search for drugs that simultaneously affect both the psychogenic factor of the disease (anxiety, depression, asthenic syndrome) and the erection mechanisms themselves.

Trazodone hydrochloride (trittico) is used as an antidepressant and has anti-anxiety (anxiolytic), sedative and hypnotic effects. Because of the reported improvement in erectile function with trazodone, this drug has been used to treat erectile dysfunction (8).

The mechanism of action of trazodone (trittiko) is associated with selective suppression of serotonin reuptake and a powerful blockade of 5HT2a receptors _, , which causes its antidepressant effect. Antagonism towards α2-adrenergic receptors of the smooth muscles of the vessels of the penis and smooth muscles of the cavernous bodies, leading to their relaxation, possibly causes the effect of trazodone to induce an erection and improve erectile function. (9,10) .

Moderate blockade of 5HT1a serotonin receptors (10 times less than 5HT2a), reduces the likelihood of their hyperstimulation effect, and the manifestation of side effects characteristic of selective serotonin reuptake inhibitors, such as psychomotor agitation, restlessness, insomnia, headache, anxiety , loss of appetite, nausea, vomiting and diarrhea.

Thus, the mechanism of action of trazodone (trittico) suggests the possible effectiveness of the use of this drug in the complex treatment of psychogenic erectile dysfunction and erectile dysfunction of mixed origin, where the psychogenic component is clinically significant.

In the foreign literature, there are a number of studies on the use of trazodone for the treatment of erectile dysfunction.

G. A. Fink et al conducted a meta-analysis of the Medline database and the Cochrane Library from January 1966 to May 2002 (11). Six studies with 396 male subjects met the inclusion criteria. Three studies showed a significant clinical effect of trazodone in the treatment of erectile dysfunction compared with placebo. Two studies showed a statistically significant efficacy of trazodone compared with placebo (37% versus 20%). The analysis performed suggested that men with psychogenic erectile dysfunction are more likely to have satisfactory results from taking trazodone than men with mixed or organic erectile dysfunction. The effectiveness of trazodone in the treatment of erectile dysfunction also depended on the dose of the drug, the best result was achieved when taking 150-200 mg per day than when taking 50 mg. The conclusion from this work is that trazodone may improve erectile quality in men with erectile dysfunction, especially at higher doses and in men with psychogenic erectile dysfunction (10).

A study by Kurt W 1994. (12) showed a greater likelihood of three or more successful intercourse attempts in patients with psychogenic erectile dysfunction treated with trazodone compared to those treated with placebo .

In a study by Montorsi F. 1994 (13) in men with psychogenic erectile dysfunction, it was shown that trazodone 50 mg per day in combination with yohimbine 5 mg three times a day had more likely to have a satisfactory erection than with placebo (50% versus 11%).

At the same time, in a study by Costabile R.A. 1999 (14), in which men with organic erectile dysfunction participated, treatment with trazodone at a dose of 50 mg per day improves erection no better than placebo.

In a meta-analysis of 6 studies, Fink et al. G. A. 2003 (11) report the following side effects of trazodone: dry mouth (19% vs. 11% with placebo), sedation (16% vs. 6%) , dizziness (16% vs 0%) and fatigue (15% vs 8%). Priapism was observed in only one man taking trazodone in one of the studies, in the placebo groups this effect was never seen.

In the domestic literature there are separate studies on the use of the drug trazodone (trittiko) for the treatment of erectile dysfunction.

Tak Tkachuk V.N., Lukyanov A.E 2006 (15) in his study involving 135 patients with psychogenic erectile dysfunction aged 22 to 56 years (mean was 32.2±3.4 years ) Trittico was used at a dose of 150 mg once a day for 6 weeks. The IIEF scale was used to assess the effectiveness of treatment.

Erectile function after treatment with trazodone (trittiko) was satisfactory.

Materials and methods.

The data of our study at the polyclinic base of the Clinic LLC “City Hospital No. 41” and the Clinic “Health 365” from 2007 to 2010 include 36 patients who were prescribed trittiko due to various sexual problems, the age of the patients was from 17 up to 53 years old.

All patients were divided into three groups.

The first group included patients suffering from various sexual disorders, predominantly of psychogenic origin, but with satisfactory erectile function, a total of 6 patients.

The second group included patients suffering from purely psychogenic erectile dysfunction, a total of 20 patients.

The third group included patients with mixed erectile dysfunction, where the psychogenic component was clinically significant, in total 10 patients.

All patients in the complex of treatment included rational and suggestive psychotherapy, selective partner sex therapy and the drug trazodone (trittiko) 150 mg per day for 30-60 days. In addition, depending on the nature of the etiological factor and the severity of the disease, the treatment complex included adaptogens, type 5 phosphodiesterase inhibitors, and local decompression courses.

Results were assessed using the International Erectile Function Index (IIEF).

Results.

First group.

It included 6 patients aged 17 to 33 years. All of them suffered from neurosis of expectation of failure, and in 2 patients the neurosis was combined with a depressive syndrome and decreased libido, in another 2 patients with psychogenic anejaculatory syndrome and in 2 patients with premature ejaculation syndrome. All patients were prescribed trazodone (trittiko) at a dose of 150 mg for 60 days as monotherapy. Against the background of drug therapy for the treatment of failure expectation neurosis, rational and suggestive psychotherapy was carried out, and for the treatment of psychogenic anejaculatory syndrome and premature ejaculation syndrome, partner sex therapy was carried out.

General satisfaction with sexual function in patients of this group after treatment increased from 4 to 9 points.

Second group.

It included 23 patients with psychogenic erectile dysfunction aged 20 to 52 years. All of them suffered from failure expectation neurosis of varying degrees. At the same time, in one patient, neurosis was combined with an organic personality disorder, in two – with severe onanophobia, which led to social maladaptation of patients, in two – with a syndrome of coded sexual reactions, and in one – with a hysterical syndrome. The patients of this group were divided into three subgroups according to the degree of erectile dysfunction.

1. Of seven patients with mild erectile dysfunction, trazodone (trittico) was given as monotherapy, and five were given in combination with phosphodiesterase type 5 inhibitors with good effect.

Erectile function score increased from 17 to 23 points.

2. Of the eight patients with moderate erectile dysfunction, in addition to trazodone (trittico) and phosphodiesterase type 5 inhibitors, two were prescribed aphrodisiacs, and two additionally received a course of local decompression.

In six patients the result was satisfactory. The evaluation of erectile function has risen from 11 to 23 points.

In one patient with psychogenic erectile dysfunction, which included hysterical neurosis, the administration of trazodone (trittiko) and type 5 phosphodiesterase inhibitors in combination with rational and suggestive psychotherapy did not lead to an improvement in erectile function. Subsequently, the patient was referred to the Clinic of Neurosis for specialized psychotherapeutic treatment.

In one patient with psychogenic erectile dysfunction due to coded sexual response syndrome and prolonged sexual abstinence, despite the appointment of trazodone (trittiko), phosphodiesterase type 5 inhibitors, adaptogens in combination with rational and suggestive psychotherapy did not lead to an improvement in erectile function. He refused further treatment.

3. Of eight patients with severe erectile dysfunction, in addition to trazodone (trittico) and phosphodiesterase type 5 inhibitors, two additionally received a course of local decompression. In 7 patients the result was satisfactory. The evaluation of erectile function has risen from 8 to 22 points.

One patient, despite taking trazodone (trittico), phosphodiesterase type 5 inhibitors, adaptogens, as well as multiple sessions of rational and suggestive psychotherapy, the neurosis of expectation of failure turned out to be extremely resistant, and there was no improvement in erectile function, he was offered endophalloprosthetics.

Third group.

It included 7 patients with mixed erectile dysfunction aged 21 to 51 years. All patients in this group were diagnosed with failure expectation neurosis, while in 4 patients erectile dysfunction had a significant vasculogenic factor, 2 had androgen deficiency, and 1 had a neurogenic factor (Thompson’s myopathy). All of them had a predominantly severe degree of erectile dysfunction.

Patients with androgen deficiency, in addition to testosterone replacement therapy, were prescribed trazodone (trittiko) and phosphodiesterase type 5 inhibitors with good effect.

A patient with Thompson’s myotonia, in addition to the main neurological treatment, was also prescribed trazodone (trittiko) and phosphodiesterase type 5 inhibitors with good effect.

Of the four patients with a vasculogenic component of erectile dysfunction, two received trazodone (trittico) in combination with a phosphodiesterase type 5 inhibitor, and another two were treated with local decompression. In two patients, the course of treatment was effective. Erectile function score rose from 7 to 22 points. Two patients with venous erectile dysfunction had no effect from the treatment.

Subsequently, due to the distal form of venous insufficiency of erection, an operation was performed to ligate the deep dorsal vein and circumflex veins with a good effect.

In the second patient, surgical treatment of venous erectile dysfunction did not give any effect, and the patient underwent endofalloprosthesis.

Conclusions.

1. In general, the drug trazodone (trittico) showed good efficacy in the treatment of psychogenic erectile dysfunction and erectile dysfunction of mixed origin, where the psychogenic component is clinically significant.

2. In some cases of psychogenic erectile dysfunction, in addition to the standard complex of treatment, including rational and suggestive psychotherapy, trazodone (trittiko), phosphodiesterase type 5 inhibitors, adaptogens, local decompression, specialized psychotherapeutic treatment is indicated when the sexological syndrome is only a component of a psychopathological disorder .

3. In cases of erectile dysfunction of mixed origin, with a significant vasculogenic component, treatment of vasculogenic dysfunction should be carried out first, despite the large clinical significance of the psychogenic component.

Literature.

1. NIH Consensus Conference. Impotence. NIH round table on consensus building on impotence. JAMA, 1993; 270: 83-90

2. Litvin M.S., Nid R.J., Dhanani N. The impact of health status on quality of life in men with erectile dysfunction. Journal of General Medicine of Internal Diseases, 1998; 13: 159-66

3. Melman A., Gingell J.C. The epidemiology and pathophysiology of erectile dysfunction // J. Urol. – 1999.

4 . Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB.

Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the

Massachusetts male aging study. J Urol 2000;163(2):460-3. PMID: 10647654

5. Feldman H. A., Goldstein I., Hatzichristou D. G. et al. Impotence and its medical ad psychosocial correlates: results of the Massachusetts Male Aging Study. J. Urol. (Baltimore) 1994; 151:54-61.

6. Pushkar D.Yu. Rasner P.I. Drug treatment of erectile dysfunction: a preliminary comparison of existing methods. Pharmateka. 2004. No. 3/4. C. 1-4.

7. Lizza E.F., Rosen R.C. Definition and classification of erectile dysfunction: Report of the Nomenclature Committee of the International Society of Impotence Research. // Int J Impot Res – 1999.

8. Lance R., Apbo M., Kostable R. A., Stears W. D. Oral trazodone as empiric treatment for erectile dysfunction: a retrospective review. Urology, 1995; 46: 117-20

9. Erdpi I. New oral therapies for the treatment of erectile dysfunction. British Journal of Urology, 1998; 81: 122-7

10. Krege S., Göpel M., Sperling G., Michel M. K. Affinity of trazodone for α1-α2 adrenoceptors of the penis in humans. BJU Int, 2000; 85: 959-61

11. . A. Fink, R. McDonald, I. R. Rootks, and T. J. Wilt. Trazodone as a treatment for erectile dysfunction: a systematic review and meta-analysis Minneapolis, USA. BJU International, 2003.

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Express Calm for dogs of small breeds 6 tablets – From stress – Veterinary pharmacy

Express Uspokoyin is the only sedative drug on the Russian market for a quick and effective solution of behavioral problems in dogs in stressful situations: on a trip, during loud noises, when visiting a veterinarian or a groomer, when parting with the owner, when moving to a new house or at overexposure .

Express Calm confidently solves the behavioral problems of animals due to its composition. The drug contains the active ingredient trazodone succinate, an original patented development.

Purpose
Express Uspokoyin tablets are prescribed for dogs to correct behavioral reactions, reduce the degree of excitation during stress and phobias caused by separation from the owner, fireworks, visits to veterinary clinics and stay in a hospital, loud sounds and transportation.

Composition
1 tablet contains: trazodone succinate – 24 mg.

Trazodone, a triazolopyridine derivative, which is part of the preparation, is an alpha1-adenoreceptor antagonist, having a sedative and anxiolytic effect, reduces the severity or suppresses the manifestation of fear, anxiety, somatic symptoms of anxiety: palpitations, salivation, excessive motor activity, vocalization (barking, howling ), destructive behavior, has a calming effect, reduces tension.

The mechanism of action of trazodone is associated with its high affinity for subtypes A and C of 5-HT serotonin receptors, with which it enters into antagonistic or agonistic interaction depending on the subtype, as well as with the specific ability to cause inhibition of serotonin reuptake.

Absorption of trazodone from the gastrointestinal tract after oral administration is high. Taking the drug during or immediately after feeding slows down the rate of absorption of trazodone, reduces its concentration in blood plasma and prolongs the time to reach maximum concentration. Trazodone penetrates through histohematic barriers, as well as into tissues and fluids (bile, saliva, milk), is metabolized in the liver to form metabolites, including the active metabolite, m-chlorophenylpiperazine. It is excreted from the body mainly in the form of inactive metabolites, mainly with urine (about 75%) and partly with bile.

Application and dosage
Express Calm tablets are administered to animals orally, forcibly on the root of the tongue 1 hour before or 2-4 hours after feeding, at a daily dose of 6-12 mg of trazodone succinate per 1 kg of body weight.

The dose of the drug is selected individually, taking into account the type and weight of the animal, the type of nervous activity and the degree of excitation.