Priapism can affect males of all ages, starting from infants, and there can be various reasons behind it, like Sickle cell anemia and blood pressure medications.

The overall incidence of Priapism is estimated to be between 0.73 to 5.4 cases per 100,000 men per year.

When an erection occurs without any sexual stimulation and continues for more than four hours, it may be Priapism.

It is a condition characterized by a prolonged and often painful erection.

This is an abnormal condition and should be treated as a medical emergency.

Trazodone, an anti-depressant, has been linked to this condition.

This article helps to explain the connection between Priapism and Trazodone, Trazodone Priapism management, and alternative treament options.

The Priapism-Trazodone relation

It should be remembered that Priapism can affect males of all ages, including children, as the erection is free from any sexual desire.

There are two types of Priapism: Ischemic (low-flow) and Non-ischemic (high-flow).

Both types of Priapism have different symptoms and treatment options.

Trazodone is a medication that is commonly used to treat Depression.

But, surprisingly, a small percentage of Trazodone users have experienced Priapism.

While the incidence is rare, knowing about this side effect and ways to manage it is crucial for those men using Trazodone.

Fact:
The majority of cases of Trazodone-induced Priapism occur within the first 28 days of Trazodone treatment.

How Trazodone can cause Priapism

The exact mechanism between Priapism and Trazodone is still unclear.

However, it is believed that Trazodone’s impact on Serotonin receptors and its ?-adrenergic blocking activity causes Priapism in rare cases.

?-adrenergic receptors specifically respond to the presence of Adrenaline (Epinephrine) and Noradrenaline (Norepinephrine) in the body. 

These receptors are responsible for initiating the “fight or flight” response in the sympathetic nervous system.

The different possible explanations of Trazodone-Priapism occurrence have been mentioned below.

  • Alpha-1 adrenergic blockade: Trazodone can interfere with the normal constriction of blood vessels in the penis, leading to the development of Priapism. This is because it inhibits alpha-1 adrenergic receptors, which control smooth muscle contraction and blood flow in several tissues, including the penis
  • Norepinephrine modulation: Trazodone impacts Norepinephrine reuptake, affecting the sympathetic nervous system, which regulates processes like blood vessel constriction. An imbalance in this system may lead to abnormal blood flow in the penis, possibly causing Priapism
  • Serotonin modulation: Trazodone affects Serotonin levels, which regulate mood and physiological processes. It may impact smooth muscle activity and blood vessel control in the penis, although the connection to Priapism is still unclear

However, Trazodone users should remember that not all users of the medication will face this issue.

The Trazodone Priapism risk has a very low rate. 

Priapism caused by Trazodone is more likely at larger doses, and factors such as individual predisposition, underlying medical problems, and medication interactions can also increase the risk.

Warning:
Do not take Trazodone if you are allergy-prone.
In addition to Priapism, it can cause a severe allergic reaction, leading to troubled breathing, swelling of the face, tongue, eyes, or mouth, rash, hives, or blisters, alone or with fever or joint pain.

Trazodone-Priapism management

Man taking consultation from a doctor
Inform your doctor while taking the medication

If someone experiences Priapism after taking Trazodone, they should immediately seek emergency care.

An erection lasting more than a couple of hours can damage penis tissues permanently and cause long-term ED (Erectile Dysfunction). 

If the Trazodone-Priapism occurrence becomes recurrent, a doctor may adjust the Trazodone dosage or prescribe an alternative medication.

To manage Trazodone-induced Priapism, an individual can use the strategies given below:

  • Stopping Trazodone: If Trazodone seems to be the reason behind Priapism, one should discontinue taking it. However, they should do this under the guidance of their doctor
  • Seeking prompt medical attention: As Priapism is a medical emergency, any individual experiencing it should seek medical care as soon as possible. This can include reaching out to a medical expert, going to an urgent treatment center, or visiting an emergency room
  • Not delaying treatment: The risk of permanent damage to the tissues in the penis keeps increasing with the delay in treatment. This also increases the chances of long-term ED set in
  • Informing doctor: When seeking medical help, one should tell the doctor about any medications they’re taking, including Trazodone. This information will aid in tailoring the therapy and Priapism management strategy

Medical treatment for Trazodone-induced Priapism

In terms of medical care, patients are frequently instructed to stop taking Trazodone and are usually treated with corporal aspiration.  

Trazodone is known to induce Ischemic Priapism, also referred to as low-flow veno-occlusive Priapism.

The medical treatment options for it include

  • Aspiration and irrigation: Aspiration, which involves withdrawing trapped blood from the penis using a needle and syringe, is a frequent first-line treatment. This may lessen the discomfort and pressure. In certain situations, the surgery is followed by irrigation, which involves injecting a saline solution into the penis to clear out the stagnant blood
  • Medications: Some medications, such as Phenylephrine, can be injected into the penis to narrow the blood vessels and lower blood flow. These vasoconstrictors help the blood circulation to become normal
  • Shunt procedures: Surgical shunt operations may be considered if all previous approaches fail. To allow the engorged erectile tissue to drain correctly, these procedures involve creating a passageway to divert blood flow. When conservative methods fail, shunt operations are usually employed 
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Alternative treatments

a person applying ice pack
Cold compresses

To avoid tissue damage, Trazodone-induced Priapism is usually treated by emergency urological intervention. 

However, alternate treatments and supportive measures might be tried while waiting for urologic consultation. 

These might include:

  • Cold compresses: Applying cold compresses to the genital area can help alleviate discomfort and reduce swelling while waiting for medical intervention
  • Oral hydration: Maintaining appropriate oral hydration while waiting for medical attention might help. Hydration is essential for general health and can help the body’s natural healing processes

It is vital to remember that these actions are only supplemental and shouldn’t replace immediate medical treatment. 

Priapism is a urologic emergency and requires prompt medical attention to avoid consequences. 

People experiencing Priapism should get evaluated and treated by a doctor immediately to avoid tissue damage and long-term issues.

Conclusion

Priapism is a serious medical condition that Trazodone, an anti-depressant medication, can cause. 

The link between Priapism and Trazodone is believed to be due to the medication’s impact on Serotonin receptors and ?-adrenergic blocking activity.

While the incidence is rare, knowing how to manage it is important. 

Strategies include stopping Trazodone, seeking prompt medical attention, and informing the doctor about any medications being taken. 

Medical treatment options include aspiration and irrigation, certain medications, and shunt procedures.

It is important to remember that Priapism is a medical emergency and should be treated as such to avoid long-term complications such as permanent damage to the tissues in the penis and ED.

Frequently Asked Questions

Can Trazodone cause Priapism?

Yes, Trazodone can cause Priapism, though it is rare. Priapism is a prolonged and painful erection unrelated to sexual stimulation. If this occurs, seek immediate medical attention. Inform your healthcare provider of any unusual side effects while taking Trazodone.

How much Trazodone causes Priapism?

There is no specific dose of Trazodone linked to Priapism, but it is a rare side effect. Priapism is a medical emergency, and if suspected, individuals should seek immediate medical attention. It is crucial to use Trazodone as prescribed and promptly report any unusual side effects to a doctor.

Is it common for Trazodone to cause Priapism?

Priapism is a rare side effect of Trazodone. While it can occur, it is not common. If you experience a prolonged and painful erection while taking Trazodone, seek immediate medical attention, as Priapism can be a serious condition requiring prompt treatment to prevent complications.

Will Trazodone give me Priapism if I jerk off a lot?

Frequent masturbation may increase the risk of Priapism with Trazodone, but it’s not a guaranteed outcome. Priapism is a rare side effect, and individual responses vary. If you experience prolonged erections and other symptoms, consult a medical expert promptly to discuss any necessary adjustments to your treatment plan.

Citations:
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