Oral Trazodone Is Not Effective Therapy for Erectile Dysfunction: A Double-Blind, Placebo Controlled Trial

Costabile, Raymond A.; Spevak, Marianne

doi:10.1016/s0022-5347(05)68813-1

Cited by 32 publications

(16 citation statements)

References 18 publications

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“…The results of treatment appeared to be less favourable for trazodone in single trials of men with a mixed aetiology for ED or with physiological ED (Table 2). In a second subgroup analysis, the improvement with trazodone monotherapy relative to placebo appeared greater in trials that used 150–200 mg/day (42% for trazodone vs 19% for placebo; RBI 2.0; 95% CI 0.9–4.6) than in the single trial that used 50 mg/day [21] (Table 2). Finally, the data also suggested the possible importance of methodological quality on study results.…”

Section: Resultsmentioning

confidence: 99%

Trazodone for erectile dysfunction: a systematic review and meta‐analysis

Fink

MacDonald²,

Rutks³

et al. 2003

BJU International

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Evidence‐based medicine is an important way of allowing the reader to judge clearly whether a treatment has a place in a particular condition, and to see what faults were present in the various trials of its efficacy. It is often rather unsettling to read in a meta‐analysis or in a systematic literature review how poorly constructed many trials are. The authors from Minneapolis have carried out such a study into the use of trazodone in male erectile dysfunction. They draw attention to the poor quality of many of the trials and give their reasons for this observation. They suggest that trazodone may be helpful in men with this condition, possibly at higher doses and in men with psychogenic erectile dysfunction. OBJECTIVE To determine the efficacy and safety of trazodone in the treatment of erectile dysfunction (ED) in a meta‐analysis. METHODS The data sources used were Medline and the Cochrane Library databases (January 1966 to May 2002), bibliographies of retrieved articles and review articles, and conference proceedings and abstracts. Trials were eligible for inclusion in the review if they included men with ED, compared trazodone with a control, were randomized, of ≥ 7 days’ duration and assessed clinically relevant outcomes. Two reviewers independently evaluated study quality and extracted data in a standardized fashion. RESULTS Six trials (comprising 396 men) met the inclusion criteria; they consisted of heterogeneous populations, were small, brief and in some cases methodologically weak. Three of the six trials showed an apparently clinically meaningful benefit of trazodone for ED compared with placebo, the differences being statistically significant in two. In pooled results, trazodone monotherapy appeared more likely than placebo to lead to a ‘positive treatment response’, although this difference was not statistically significant (37% vs 20%; relative benefit increase, 1.6; 95% confidence interval, CI, 0.8–3.3). Subgroup analyses suggested that men with psychogenic ED might be more likely to benefit from trazodone than those with mixed or physiological ED. The efficacy of trazodone also appeared greater at higher doses (150–200 vs 50 mg/day). Men randomized to trazodone were not significantly more likely than those receiving placebo to withdraw for any reason or for an adverse event, or to have specific adverse events, but wide CIs could not exclude a greater risk of these adverse outcomes with trazodone. Specific adverse events with trazodone included dry mouth (19%), sedation (16%), dizziness (16%) and fatigue (15%). CONCLUSION Trazodone may be helpful in men with ED, possibly more so at higher doses, and in men with psychogenic ED. Future high‐quality trials should compare trazodone with placebo and other therapies in men with depression and psychogenic ED.

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Section: Resultsmentioning

confidence: 99%

Trazodone for erectile dysfunction: a systematic review and meta‐analysis

Fink

MacDonald²,

Rutks³

et al. 2003

BJU International

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“…Only one of the studies focused on older men and used trazodone at an appropriate geriatric hypnotic dose (50 mg). The mean age of patients in this study was 65 years, and the study demonstrated that trazodone, 50 mg, was no more effective than placebo in improving erectile function [31]. A recent meta-analysis, reviewing the efficacy of trazodone for ED examined six trials [32•].…”

Section: Trazodonementioning

confidence: 99%

Erectile dysfunction in the aging male

Smith

2005

Current Sexual Health Reports

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“…Other drugs, such as the antidepressant trazodone (Meinhardt et al, 1997;Costabile & Spevak, 1999), apomorphine (Heaton et al, 1995), alpha-adrenergic antagonists either alone (Becker et al, 1998) or to enhance the response of intracavernosal medication (Zorgniotti, 1994;Kaplan et al, 1998), melanotan-II (a cyclic analogue of alpha melanocyte-stimulating hormone) (Dorr et al, 1996;Wessells et al, 1998) and dehydroepiandrosterone (Reiter et al, 1999) (plasma levels of which were found to be inversely related to the incidence of erectile dysfunction in the Massachusetts Male Ageing Study : Feldman et al 1994), have not been shown to be effective.…”

Section: Other Oral Agentsmentioning

confidence: 99%