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Re: SERZONE/NEFAZODONE - PRIAPISM ???? » Tony C.

Posted by King Vultan on June 20, 2004, at 11:29:05

In reply to Re: SERZONE/NEFAZODONE - PRIAPISM ????, posted by Tony C. on June 20, 2004, at 7:31:20

> Thanks for your replies, however I believe the throbbing hardon that won't go down is a side effect of Nefazodone also, is it even greater with Trazodone ? Or the same risk ? And as for the Nortryptaline, is that like similar to the mechanisms of Serzone/Nefazodone ? Cause I have really ONLY done well on Serzone/Nefazodone. Also I am in day #20 of reducing, I am down 20% of my regular dose, and so far so good, I have gone slow enough that the withdrawal has been very light and transient, and very comfortable. I am keeping my fingers crossed.
>
> Thanks for your replies I need and appreciate them.
>
>
> Tony C.

I think people need to be aware of the risk of priapism for trazodone, but that be said, I just do not think it is worth worrying about. The truth is that other drugs with alpha-1 adrenergic blockades can also cause this (I noticed prolonged erections myself on nortriptyline, which is not really noted as a side effect of this drug). OTOH, I took trazodone as a sleep aid for a few nights earlier this year and noticed absolutely nothing of the kind.

Trazodone should be more likely to have effects in this area, however, because in addition to its alpha-1 blockade, it also has a fairly strong alpha-2 blockade, which is associated with sexual arousal (yohimbe, for example, selectively blockades alpha-2 adrenergic receptors). Add the two effects together in the same drug, and one would expect to have more of a risk of priapism. Even so, it winds up only being a rare side effect, with the number I've seen in the past being 1 out of 6-7000.

Only about half of nortriptyline's pharmacological profile is similar to that of nefazodone and trazodone. The three of these drugs all blockade serotonin 2A receptors and alpha 1 adrenergic receptors. They all are at least somewhat sedating, and none are terribly anticholinergic, with nortriptyline being the worst because it's a tricyclic that also blockades norepinephrine reuptake. I had a few months experience with nortriptyline and a few days with trazodone, and they struck me as being perhaps vaguely similar, but I do not react particularly well to sedating antidepressants.

Todd


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poster:King Vultan thread:358095
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