ORAL TRAZODONE AS EMPIRICAL THERAPY FOR ERECTILE DYSFUNCTION - A RETROSPECTIVE REVIEW

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 pat ients were placed on oral trazodone as empirical therapy for erectile dysfunction. Patients ranged in age from 26 to 85 years, with a mean o f 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. Res ults. One hundred twenty-seven patients were available for follow-up b y a standardized questionnaire regarding perceived improvement in erec tile function, sexual function, and side effects. In patients less tha n 60 years of age, with no known risk factors for erectile dysfunction , 21 of 27 (78%) showed significant improvement in erectile ability, S mokers 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 mo nths, 48% reported a positive response. Only 16% of patients with dura tion of erectile dysfunction greater than 60 months reported improveme nt in erections and sexual function. Trazodone was well tolerated by t his population, with 62% reporting no side effects. Conclusions. Despi te 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.