A guy not being to happy with what he finds in his boxer short

Trazodone and Erectile Dysfunction

Many men find that the traditional therapies just don’t do the job for them. And this is not too surprising as an erection is an incredibly complex process. Sure, when we are younger, it’s like “falling off a log,” but that can change rapidly with injury or with the abuses of a Western lifestyle.

Below, one of our guest authors documents a new medication that allowed him to actually have an erection by thought alone, something he had not done for a long time and is not a bad achievement for a guy in his late 50’s!  Of course, pharmaceutical solutions are always best considered short term solutions while you put lifestyle and other more natural solutions into place.  But these are impressive results that I thought I should pass on.

CAUTION:  Trazodone is, among other things, an alpha blocker. All the alpha blockers should only be used under a doctor’s supervision, because they 1) interact very negatively with certain medications, 2) can cause swings in blood sugar, 3) can have very serious side effects and 4) can cause priapism, an erection that does not go away and can damage the penis permanently.  See my link on Common Causes of Priapism for more information on the latter. If you ever have an erection that will no go away after an hour or two, go to the E.R. Your sex life is at stake.

NOTE:  If an alpha blocker works for you, it could be a sign of adrenal dysfunction – since it’s working on noradrenaline – and/or excess stress in your life.  Always try to get to the root causes.  See my pages on Adrenal Fatigue Testing and Cortisol and Stress Management for more information.


Trazodone is an antidepressant, of the serotonin antagonist and reuptake inhibitor (SARI) class. It is also used for sleep disorders. It was invented in the 1960s and approved by the FDA in 1981. The drug has a half-life of 3 to 6 hours. When used an anti-depressant, the starting dose is often around 100mg a day, rising to a maximum of 400mg a day for outpatients.

Anecdotal reports of increased libido and sexual function in patients taking trazodone have led to its empirical use in patients with erectile dysfunction.

Clinical Trials. A retrospective review of patient-reported responses to trazodone was reported in the July 1995 edition of Urology . In this report, relating to a period between 1989 and 1994, 182 patients were placed on oral trazodone as empirical therapy for erectile dysfunction. Patients ranged in age from 26 to 85 years, with a mean of 60 years. Patients were evaluated before receiving trazodone with a thorough medical history and physical examination. Patients received trazodone for at least 2 consecutive months, with daily doses starting at 25 mg, then and gradually increasing, to an average of 150mg a day. One hundred and twenty seven patients were available for follow-up by questionnaire. In patients less than 60 years of age, with no known risk factors for erectile dysfunction, 21 of 27 (78%) showed significant improvement in erectile ability. Smokers and patients older than 60 years with a history of 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 months, 48% reported a positive response. Only 16% of patients with duration of erectile dysfunction greater than 60 months reported improvement in erections and sexual function. Trazodone was well tolerated by this population, with 62% reporting no side effects.

In conclusion, despite 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.

A report in PubMed (Sep 2003) concluded, after looking at six trials, that Trazodone may be helpful in men with ED, possibly more so at higher doses, and in men with psychogenic ED .

Another report was published in PubMed in 2009. 20 patients (11 men & 9 women) started the trial and 15 completed it. All patients were depressed, were taking SSRIs as treatment, and were suffering from (SSRI related?) sexual dysfunction. The patients were given 50mg trazodone each day for the first week, and 100mg a day for the next three weeks. The report concluded of the subjects who completed the study: results indicated improvement in sexual function and overall clinical improvement (depression, anxiety) as well. Specific gender differences indicated improvement in erectile performance in men and lubrication in women. No correlations were noted between clinical improvement of depression or anxiety and improvement in sexual dysfunction

A 1997 trial reported that in a group of 69 patients, not selected on the basis of the etiology of the erectile dysfunction, nor selected on the duration of the complaint, the efficacy of trazodone 150 mg/d could not be shown .

A trial by Costabile and Spevak in 1999 concluded that trazodone is no more effective than placebo in improving erections and sexual function in patients with severe physiological erectile dysfunction.

Darius A. Paduch summarises this drug on the Weill Cornell Medical College s website. Trazodone is an anti-depressant with the uncommon side-effect of priapism in approximately 1/10,000-20,000 users. It has been used for the treatment of erectile dysfunction without any clear evidence that it is truly effective. Its mechanism of action in promoting erection is not well known, but it is believed that it exerts its primary effect by stimulation of the serotonin receptors in the brain. The medication has been used at the dose of 50-200 mg by mouth each night at bed time (no relationship to intercourse timing). While some studies have cited trazodone s effectiveness to be as high as 60%, the arrival of Viagra has decreased the use of this medication significantly. The side effects of trazodone include drowsiness in 31%, dry mouth in 1% and fatigue in 19%. At the Sexual Medicine Program the combination of trazodone and PDE5 inhibitors can only be used in men failing to initial therapy with maximum dose of PDE5 inhibitor

As Trazodone may be helpful for insomnia, and insomnia is another cause of poor erectile function, perhaps insomniacs for whom Viagra has ceased working might be most likely to benefit.

Dependency? One Thai website reports that trazodone is the 17th-most abused drug in the USA. As both an antidepressant and a sleeping pill, the reasons for addiction are that an individual feels they cannot live life normally without it. This dependency can result from improper use and a lack of supervision of a patient suffering from depression, anxiety or insomnia. One reason for the drug s addictive quality is that it Trazodone works rapidly, achieving full absorption within approximately an hour of ingestion. As such, it can seem to offer a quick fix to life s problems and may be viewed as an easy solution for those who are clinically depressed or suffering from severe lack of sleep.

When combined with other substance dependency, Trazodone also has the potential to heighten this abuse and cause a relapse in recovering patients. This is especially true when it comes to alcohol, as the drug has been shown to increase an alcoholic s chances of reverting back to their old ways if they are undergoing therapy. After the intake of Trazodone is ceased, an individual recovering from alcohol addiction may then fall back into misuse and dependency.

My Trial. My trazodone arrived on 23rd Sept 2013, I took 25mg that day and 50mg for the next three days, then 100mg a day, divided into two doses. After the first day I thought yes, perhaps it helps ; but over the next 48 I thought the opposite. On the fifth day I took 100mg, and noticed unusually strong npt that night. And I didn t wake up at 3am, as I usually do. And seem to have gained weight, and have generally felt sweaty . By the tenth day I again doubted any positive effect, but by the thirteenth day I was again becoming convinced of its benefit.

I ceased taking trazodone one month after starting, as ten days previously I had started taking citrulline, and I presumed that continued improvements were down to the citrulline, not the trazodone. But I now think I was wrong, the improvements reversed. So I resumed the trazodone five days later, and after a further week I felt highly encouraged, – as whilst lying in bed after waking too early induced several lasting erections by thought alone. That was this morning and yesterday. So I m impressed with trazodone. But I m still on about 3 or 4mg citrulline a day, and it s hard to be sure what effect each would have on their own.

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