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Trazodone and erections

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Posted

I find trazodone enormously helpful for sleep, but I always wake up with an erection when I take it. I don't know how long these erections are lasting, but I think for several hours. I generally take 7.5 mg when I turn in, then 7.5 mg about 5 hours later, which puts me under for another two hours. I don't have an erection when I go to sleep, only when I wake up. Ejaculation just prior to sleep doesn't seem to have any effect.

It's not exactly a priapism, because as soon as I rise, the erection subsides, but it's cause for serious concern. I have been taking trazodone for about six months, and over the last month or so, a steady ache deep in my penis has developed. It seems to be worst when I awaken, after the erection subsides, and get gentler throughout the day. This ache seems to have been getting worse over the last few weeks, and I am worried about the long-term effects.

When I first started taking trazodone, I would get an erection from it even prior to sleeping. I found spreading it out over two doses helped this. I am going to experiment with spreading it out further, say to four doses of 3.25 mg a night.

I am looking for other suggestions for managing this problem. Unfortunately, the medical solutions for persistent erection all seem to be very crude and surgical. I am surprised there are no chemical approaches to the problem. Just based on Murphy's Law, I am quite surprised that there are no otherwise harmless drugs out there which happen to have the unfortunate side-effect of temporarily causing impotence.

Suggestions for alternative sleep aids are also welcome. But I quickly develop a tolerance for antihistamines and benzos, and lunesta gives me horrible nightmares which cause me great anxiety throughout the day.

I also asked about this anonymously over on metafilter, which is how I found this site. I am not the same person as metafilter's proteus, although I took the same username over here. (Didn't think about that potential problem until I'd already signed up.)

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Posted

Have you discussed this with your doctor? Also, why are you taking such a low dose? Typical doses of trazodone for sleep are 50 - 150 mg or so. I didn't know it came in pills that small. Are you sure that's not 75mg rather than 7.5?

Splitting the dose into increments throughout the night would kind of defeat its purpose as a sleep aid, wouldn't it? As would constant worry about this side effect?

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Posted

I intend to talk to my doctor about it this week. I only really started to worry about this yesterday, though. I always prefer to do some research before seeing him, when there's time.

The doctor started me on a low dose, and it seems to have a significant effect on my sleep, so I haven't really increased it. (I've gone to 22.5 mg during some really stressful times.)

Yep, the worry and the sleeplessness are both problems. That's why I'm asking for help with these questions.

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Posted

If this is painful and not a typical morning erection, you need to be talking to your prescriber about it, soonest. I'm glad you're seeing your doctor this week. Calling tomorrow wouldn't be bad either.

There are non-surgical ways of reducing priapism for emergency care, but it isn't something that should be a chronic-management situation. Long-term effects are a risk.

There are a lot of other ways of handling sleep problems. Treating the underlying pathology, behavioral sleep med, et cetera. In general, most prescribers probably aren't going to treat the side effect - they're going to change the therapy, as there are other options.

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Posted

Yeah, done chronically, the nonsurgical options are just as destructive as chronic prolonged erections. And a hell of a lot more inconvenient. ;)

You are correct that he's probably going to change the treatment. That's probably one reason I've held off. I don't want to go back to my earlier sleep-deprived state. If it comes down to a hard choice between sleeping relatively well and losing the capacity for an erection, I will probably go for the sleep. (I realize there are many alternatives still to try before that, but I'm pessimistic about them working.)

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Posted

I find trazodone enormously helpful for sleep, but I always wake up with an erection when I take it.

Unless you're female, waking up with "morning wood" is normal, but it shouldn't be painful.

I suppose there's always Prozac. The SSRIs are notorious for having sexual dysfunction as a side effect. ;)

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Posted

I can tell you seroquel knocked me out and continued knocking me out for the full three months I took it. GLAD to be off it, I had to stop taking the trazadone I take still when on the seroquel, because within fifteen minutes my eyes would start closing and I couldn't stay awake. Best of luck finding relief for your sleeping issues while finding relief for the uncomfortable errections. Elavil is another I used to use for sleep related issues and it worked like a charm too, but I think Trazadone is a bit stronger for me. ;)

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Posted (edited)

Thanks, guys. The SSRIs, seroquel and elavil are all very useful suggestions. So, Elavil looks like a good thing to try next.

Anyone know what the worst SSRIs are, erection-wise?

Edited by proteus

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Posted

Why not just switch from Traz to another option for sleep?

Honestly, I've seen so many people have so much trouble with insomnia, I'm not keen on suggesting a switch away from something non-addictive that works.

Where do SSRIs come in here? They aren't sleep meds. Nor is Elavil. Null was referring to the fact that SSRIs can cause erectile dysfunction. You don't want that, do you?

I'd made the suggestion only partly in jest, precisely because of the dysfunction IF the OP's doctor can't find some organic reason for the problems keeping it down.

Also, trazodone is a really odd med to use for sleeping problems alone as it is a tricyclic AD. Elavil might actually make things worse - it for sure has some noradrenaline reuptake inhibition, which could be what he's sensitive to.

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Posted

Besides, everyone knows MY sleepytime meds are counter-productive to vertebrates with a normal nervous system.

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Posted

The emedicine overview is a good one. Look in the sidebar for the emergency-med version, too.

If you can get the Now Up To Date overview (can't link, that's a paid site, but most universities with health programs will have it), it's very good.

It addresses some of the basic med questions in the above posts. There are many other substances and conditions that can cause this... so... this is one of those talk to your psychiatrist moments. You're taking a minuscule dose of trazodone to be inducing a response.

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Posted

I misremembered the dosage, yesterday. I looked at the bottle just before bed, last night, and they're actually 50mg tablets. So I've been taking two 25mg doses a night, separated by a few hours.

Regarding SSRIs, frankly, if a better solution doesn't come along, I would be quite prepared to use them to temporarily induce erectile dysfunction so that I can sleep well and not have to worry about damaging myself in the process. I like sex, but I like being a functional adult even more. (My girlfriend pointed out last night that actually, these erections are a form of erectile dysfunction themselves. ;))

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Posted

SSRIs don't guarantee erectile dysfunction. Which means it's probably not the best med to fix whatever you have going on.

No one's arguing against seeing a GP, and probably a urologist is needed, before a nagging problem turns itself into a medical emergency (all it takes is one clot, and the little bastards don't always stay in one place.)

I suppose he can talk to his doctor about taking OTC pseudoephedrine when he wakes up, to reduce the symptoms until he can get in for a more specialized exam. No guarantees on that either.

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Posted

Sounds like adolescence, other than the ache. Have you had a physical lately? How's your blood pressure? I don't know if it's the usual medical approach or even indicated, but I wonder if a blood pressure medication would soften things up just a bit and relieve the ache? At one point, years ago, I was taking Verapamil. Softened things right up, but also made me relaxed and happier, although that's not what I was taking it for. Still, that's probably a bit on the heavy duty side.

I don't know just what dx you have. For people with ADD who have trouble sleeping, clonidine is often prescribed. It also lowers blood pressure a bit.

(I'm just guessing about the blood pressure thing, I could be completely off base. I don't even play a doc on public access TV.)

Agree that you should see a doc on this pretty soon. You may find that it's some other problem.

I find trazodone enormously helpful for sleep, but I always wake up with an erection when I take it.

snip (hmmm... maybe not such a great word here ;-p)

It's not exactly a priapism, because as soon as I rise, the erection subsides, but it's cause for serious concern. I have been taking trazodone for about six months, and over the last month or so, a steady ache deep in my penis has developed.

snip

I also asked about this anonymously over on [link=http://ask.metafilter.com/125964/Is-there-an-antiViagra" target="_blank]metafilter[/link], which is how I found this site. I am not the same person as metafilter's [link=http://www.metafilter.com/user/88395" target="_blank]proteus[/link], although I took the same username over here. (Didn't think about that potential problem until I'd already signed up.)

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Posted

I might also have guessed adolescence, given the information you have, but it turns out I'm almost 37. ;)

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Posted

I know Elavil is a AD but my pain doc rx'd it to me for years at 100 mgs before bed to help sleep and to help with pain, nerve pain. I don't know if it would help you or not proteus, I just hope you find some relief soon. That is really scary stuff. ;)

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Posted

I know Elavil is a AD but my pain doc rx'd it to me for years at 100 mgs before bed to help sleep and to help with pain, nerve pain. I don't know if it would help you or not proteus, I just hope you find some relief soon. That is really scary stuff. ;)

Elavil (amitriptyline) works very well for some people with pain - especially neuropathic pain.

In the case of someone with chronic pain, it can be very useful. However it also changes the sleep cycle and shortens the duration of REM sleep. It can be used for insomnia in low doses, but (if insomnia is the main complaint) there are other meds more appropriate for sleep without taking the risk of reduced REM sleep.

~ May

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Posted

I know Elavil is a AD but my pain doc rx'd it to me for years at 100 mgs before bed to help sleep and to help with pain, nerve pain. I don't know if it would help you or not proteus, I just hope you find some relief soon. That is really scary stuff. ;)

Elavil (amitriptyline) works very well for some people with pain - especially neuropathic pain.

In the case of someone with chronic pain, it can be very useful. However it also changes the sleep cycle and shortens the duration of REM sleep. It can be used for insomnia in low doses, but (if insomnia is the main complaint) there are other meds more appropriate for sleep without taking the risk of reduced REM sleep.

~ May

Wow May, I am glad I am off elavil, trazadone works wonders for me, it doesn't help manage the pain but I take vicodin and robaxin for that...I just love learning new things about meds, I like to be a more informed consumer of drugs, it's our responsibility after all to monitor what we put into our bodies...

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Posted

You might have decent luck combining trazodone with a medicine known to reduce erections, such as a 5-aR inhibitor such as finasteride, better known by the brand-name Propecia (1mg) or Proscar (5mg).

Technically, its for prostate enlargement, or hair loss, but definitely has an effect on the strength of erections in most men that take it.

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Posted

I have been on ED meds for a long time. I started back in the early 90's with self injections. It gives you an erection for almost 5 hours which was very painful.

The easiest way too get rid of an erection is Sudafed, the cough medicine. You take a tablespoon and your erection is down in a minute or two.

Sudafed lowers your blood pressure.

I hope this helps.

Ted

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