Lance R, Albo M, Costabile R A, Steers W D
Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Urology. 1995 Jul;46(1):117-20. doi: 10.1016/S0090-4295(99)80176-9.
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.
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. 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.
One hundred twenty-seven patients were available for follow-up by a standardized questionnaire regarding perceived improvement in erectile function, sexual function, and side effects. 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 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 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.
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.
有传闻称服用曲唑酮的患者性欲和性功能增强，这使得该药被经验性地用于治疗勃起功能障碍患者。对患者报告的曲唑酮反应进行回顾性分析，以概述该药物的疗效和副作用情况。
1989年至1994年间，182例患者接受口服曲唑酮作为勃起功能障碍的经验性治疗。患者年龄在26岁至85岁之间，平均年龄为60岁。在接受曲唑酮治疗前，对患者进行了全面的病史询问和体格检查。根据病史信息和检查结果确定已知的勃起功能障碍风险因素。患者连续至少服用曲唑酮2个月，起始日剂量为25毫克。
127例患者通过标准化问卷进行了随访，问卷内容涉及勃起功能、性功能的感知改善情况以及副作用。在年龄小于60岁、无已知勃起功能障碍风险因素的患者中，27例中有21例（78%）勃起能力有显著改善。吸烟者以及年龄大于60岁且有严重外周血管疾病史的患者对曲唑酮治疗反应较差。勃起功能障碍的持续时间与对曲唑酮的反应呈负相关。阳痿持续时间小于12个月的患者中，48%报告有阳性反应。勃起功能障碍持续时间大于60个月的患者中，只有16%报告勃起和性功能有改善。该人群对曲唑酮耐受性良好，62%的患者报告无副作用。
尽管这项非随机、回顾性研究存在局限性，但曲唑酮似乎对已知风险因素较少的年轻勃起功能障碍患者有益。需要进行一项前瞻性、安慰剂对照试验来证实这项初步研究的观察结果。
