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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Buckeye Maniac on January 5, 2007, at 15:13:46
Hi guys,
I had to re-register...but this is Buckeye Fanatic...
I am in Intensive Outpatient Therapy to taper off Xanax ( 10 year use...6mgs per day) and also to never drink alcohol again.( I got a DUI Dec6)
I am currently on a daily doseof 200 mgs of Zoloft
3mgs of Xanax
80 mgs of Librium
1000 mgs Naprosen for sever Arthritic Kneesand my PDoc just added 50-100mgs of Trazadone
because I cannot fall asleep, stay asleep allnight and I wake too early.I took my first dose of Trazadone last night...and I couldnt really tell any immediate effects, except I was a little groggy in the morning.
Also...and this is embarrasing...one of the possible side effects is...well...uhhh..sustained erections. This DID happen last night...the reason I am sure it was the Trazadone is because the PDoc upping my Zoloft to 200 mgs has completely shut down my libido.
Any suggestions or explaination on WHY an old antidepressant like Trazadone effects erections???? I dont get the connection
BM
Posted by UGottaHaveHope on January 5, 2007, at 15:46:52
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
Thats good question. Im sure someone on this board will be able to give you a better answer. This is just what I pasted from a website.
http://www.mentalhealth.com/drug/p30-d03.html
Trazodone has been associated with the occurrence of priapism. In approximately 33% of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted. Male patients with prolonged or inappropriate erections should immediately discontinue the drug and consult their physician. If the condition persists for more than 24 hours, it would be advisable for the treating physician to consult a urologist or appropriate specialist in order to decide on a management approach. Recent clinical studies in patients with pre-existing cardiac disease indicate that trazodone may be arrhythmogenic in some patients in that population. Arrhythmias identified include isolated PVC's, ventricular couplets, and in 2 patients short episodes (3 to 4 beats) of ventricular tachycardia. There have also been several post-marketing reports of arrhythmias in trazodone-treated patients who have pre-existing cardiac disease and in some patients who did not have pre-existing cardiac disease. Until the results of prospective studies are available, patients with pre-existing cardiac disease should be closely monitored, particularly for cardiac arrhythmias. Trazodone is not recommended for use during the initial recovery phase of myocardial infarction.
Posted by Phillipa on January 5, 2007, at 16:56:54
In reply to Re: Trazadone, posted by UGottaHaveHope on January 5, 2007, at 15:46:52
Guess that's the end of that med. I thought it was such a good sleep agent? Love Phillipa
Posted by fca on January 5, 2007, at 18:56:06
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
IANAD but I wonder if the erection was priapism related to the trazodone are simply a normal nocturnal erection because you were able to sleep. That is a low dose of trazodone. Does not mean it could not be priapism but you might want to speak with your physician (which you should do anyway) before abandoning it. However, I would be hesitant to take it until you have clarity or reassurance. Good luck, good sleep and many ........
Posted by Quintal on January 5, 2007, at 19:47:02
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
I noticed myself having more nocturnal erections on trazodone though not priapism. Some of them were pretty stubborn into the next morning which did frighten me a bit.
Q
Posted by Buckeye Maniac on January 5, 2007, at 20:20:19
In reply to Re: Trazadone » Buckeye Maniac, posted by Quintal on January 5, 2007, at 19:47:02
Thanks for the input guys.Can anyone explain WHY it has this particulair side effect?
Most other antidepressants have just the opposite
What does Trazadone contain that makes it different?????
BM
Posted by sdb on January 6, 2007, at 3:34:38
In reply to Re: Trazadone, posted by Buckeye Maniac on January 5, 2007, at 20:20:19
Hi Buckeye Maniac,
trazodone is an alpha1-receptor antagonist. These receptors are on muscle tissue of blood vessels such as the blood vessels in the penis. There are many alpha-receptor subtypes on muscles eg. constrictors of the inner bladder muscle. Alpha1-antagonists for the treatment of prostate hyperplasia problems can cause sustained erections too.
sdb
>
> Thanks for the input guys.
>
> Can anyone explain WHY it has this particulair side effect?
>
> Most other antidepressants have just the opposite
>
> What does Trazadone contain that makes it different?????
>
> BM
Posted by Buckeye Maniac on January 6, 2007, at 5:19:48
In reply to Re: Trazadone }} Buckeye Maniac, posted by sdb on January 6, 2007, at 3:34:38
Thanks SDB,
I did some Internet surfing after reading your reply and found out more info.
I gotta tell ya.....I am considering discontiuing Trazodone ( Ive only taken it for 2 days so far) as it seem there are no good options should Priapism Occur!!!!!
http://en.wikipedia.org/wiki/Priapism
Anyway of predicting if I am at risk?
The statistics show that as many as 33% of Patients are at High Risk!!!!!!!
Somebody help please...I am a relatively young married man who has no interest in impotency or removal of my P___S !@!!!@
At the same time..as a 10 year User of Xanax...sleep is difficult for me, and Ambien and other sleep Meds are too weak and too addicitive.
Thanks in advance for any further advice or suggestions
BM
Posted by sdb on January 6, 2007, at 11:27:43
In reply to Re: Trazadone }} Buckeye Maniac, posted by Buckeye Maniac on January 6, 2007, at 5:19:48
Hi Buckeye Maniac,
50mg-100mg trazodone is a recommended starting dosage of trazodone. However this dosage can be too high for many people at the beginning. Even 25mg of trazodone can be enough first. If the not normal erections continue even at a low dosages I suggest to stop. You're right, priapism can be dangerous. For sleep there are other meds available.
sdb
> Thanks SDB,
>
> I did some Internet surfing after reading your reply and found out more info.
>
> I gotta tell ya.....I am considering discontiuing Trazodone ( Ive only taken it for 2 days so far) as it seem there are no good options should Priapism Occur!!!!!
>
> http://en.wikipedia.org/wiki/Priapism
>
> Anyway of predicting if I am at risk?
>
> The statistics show that as many as 33% of Patients are at High Risk!!!!!!!
>
> Somebody help please...I am a relatively young married man who has no interest in impotency or removal of my P___S !@!!!@
>
> At the same time..as a 10 year User of Xanax...sleep is difficult for me, and Ambien and other sleep Meds are too weak and too addicitive.
>
> Thanks in advance for any further advice or suggestions
>
> BM
>
Posted by fca on January 6, 2007, at 11:41:32
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
not 1/3 of persons it is "from Medscape:
Priapism associated with trazodone usage has been reported with a frequency ranging between 1 in 1000 and 1 in 10 000 and does not appear to be dose related.[3] In both the urological and psychiatric literature, trazodone-induced priapism is more frequently reported than that with any other psychotropic medication. However, this may be related to the widespread prescription of this antidepressant, particularly in the US.[1]
There are wide variations in the interval between initiation of drug therapy and the onset of priapism. However, the data reported to the US Food and Drug Administration suggest that this complication is most likely to occur within the first 28 days of treatment.[4]
Posted by Crazy Horse on January 6, 2007, at 12:01:50
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
I was on Traz for almost 1 year. I never experienced Priapism, which by the way is dangerous and can cause permanate damage to the penis, but i did notice i was getting more erections, or even semi-erections through the night while on this drug. No biggee..yikes, no pun intented. :)
-Monte
Posted by ed_uk on January 6, 2007, at 13:47:17
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
Hi Buckeye
You need to discuss this side effect with your doctor. Priapism can damage the penis.
Ed
Posted by yxibow on January 6, 2007, at 13:56:04
In reply to The odds in perspective--it is, posted by fca on January 6, 2007, at 11:41:32
> not 1/3 of persons it is "from Medscape:
>
> Priapism associated with trazodone usage has been reported with a frequency ranging between 1 in 1000 and 1 in 10 000 and does not appear to be dose related.[3] In both the urological and psychiatric literature, trazodone-induced priapism is more frequently reported than that with any other psychotropic medication. However, this may be related to the widespread prescription of this antidepressant, particularly in the US.[1]
>
> There are wide variations in the interval between initiation of drug therapy and the onset of priapism. However, the data reported to the US Food and Drug Administration suggest that this complication is most likely to occur within the first 28 days of treatment.[4]Oh goodness no, its MUCH more common than the monograph. Its an awful way to go to sleep too in my opinion, staggering, low blood pressure on the way to bed, passing out if you've had ANY alcohol before, and oh, the lovely priapisms. I had them several times. No joke, I got rid of it by standing on my head in bed and my feet on the walls so the blood went the other way... But for older patients especially, this can be, as noted, damaging or dangerous for the penis.
I'm a strong believer in sleep medicines for sleep, e.g. Rozerem, Ambien/CR/regular, etc... and not side effect meds, especially Trazodone. Remeron may be a different story other than its weight gain. Trazodone also has the metabolite mCPP, which can cause psychosis in patients susceptible to psychosis (not saying you are.)
Do mention this to your doctor and find another medication I would think, if not willing to prescribe the pseudobenzodiazepines that I mentioned (Rozerem isnt, its a melatonin receptor agonist), than at least Remeron or doxepin.
-- Jay
Posted by Dr. Bob on January 7, 2007, at 1:05:00
In reply to Trazadone, posted by Buckeye Maniac on January 5, 2007, at 15:13:46
> I had to re-register...
Did you have a problem with your old name? If so, and if you'd be willing to switch back, let me know, and I can try to figure out what happened.
Bob
Posted by sdb on January 7, 2007, at 17:42:22
In reply to Re: The odds ... are there » fca, posted by yxibow on January 6, 2007, at 13:56:04
>Trazodone also has the metabolite mCPP, which can >cause psychosis in patients susceptible to >psychosis (not saying you are.)
Hi yxibow,
I think you're right. It does not mean that everybody will have a psychosis but for the susceptible it is possible. From where do you have that information?
sdb
Posted by notfred on January 7, 2007, at 19:08:05
In reply to Re: The odds ... are there }} yxibow, posted by sdb on January 7, 2007, at 17:42:22
. From where do you have that information?
>
> sdbgoogle.
Posted by yxibow on January 8, 2007, at 3:13:39
In reply to Re: The odds ... are there }} yxibow, posted by sdb on January 7, 2007, at 17:42:22
> >Trazodone also has the metabolite mCPP, which can >cause psychosis in patients susceptible to >psychosis (not saying you are.)
>
> Hi yxibow,
>
> I think you're right. It does not mean that everybody will have a psychosis but for the susceptible it is possible. From where do you have that information?
>
> sdb
>
>As noted on that drug prevention site, I wasn't aware it was being synthesized.
But, no, it was more in an informal table discussion with doctors in neuroleptics when I had the chance to be a test case for TD at an undisclosed location and undisclosed doctors (no, I am assured by my own undisclosed psychopharmacologist that I still I do not have it but annoying EPS.)
It is fascinating though to be able to have a chance to discuss with doctors at an intellectual level with one's own gathered medical knowledge and information. I've often thought of a career in the medical field but although its possible, it is a brutal long time before you see a stable medical practice and I am currently in the throws of not a life-threatening, but life-complicating major disorder. But that is a side issue. I'm attempting to try to ressurect a life slowly after 5 years of dealing with visual Somatiform NOS.
-- tidings
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