Efficacy of Oral Trazodone for Management of Impotence

Ahn, Ki Young; Kim, Je Jong

Abstract

Many oral medications have been attempted to treat erectile impotence, but the results have not been satisfactory. Trazodone has alpha adrenergic antagonist effect locally and 5-HTlc agonist effect centrally. Therefore oral trazodone was tried to 44 impotent patients in this study. Age distribution of patients was between 25 and 63 years, with median age of 45. All men underwent a detailed history-taking, physical examination, laboratory studies and artificial penile erection test with prostaglandin E1 intracorporal injection. If vasculogenic impotence was suspected at artificial penile erection test, duplex ultrasound sonography and/or dynamic infusion cavernosometry and cavernosography were carried out. In case of suspected neurogenic impotence, BCRL and Somatosensory evoked potential tests were conducted, and confirmed neurogenic impotence were excluded in this study. Forty four patients taking trazodone were divided into 31 psychogenic impotence and 13 mild vasculogenic impotence with psychogenic components. Trazodone was administered orally 50mg each 3 times a day for 2-8 weeks. Based on the response to medication, increase in erection quality and frequency was regarded as positive, and no change in quality or deterioration as negative response. Among 31 patients with psychogenic impotence, 15 patients ( 48%) showed positive response and 16 patients (52% ) negative response. Of 13 patients( 30%) with vasculogenic impotence with psychogenic components, 2 patients( 15%) showed positive and 11 patients (85%) negative response. As side effect of drug, 15 patients complained mild drowsiness. Taking account into placebo effect, these results indicate that a prospective, randomizes and placebo controlled drug trials will be needed.