Many oral medications have been attempted to treat erectile impotence, but the results hav not been satisfactory. Trazodone has alpha adrenergic antagonist effect locally and 5-HT1c agonist effect centrally. Therefore oral trazodone was tried to
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impotent patients in this study. Age distribution of patients was between 25 and 63 years, with median age of 45. All men underwent a detailed history-taaking, physical examination, laboratory studies and artificial penile erection test with
prostablandin #1 intracorporal injection. If vasculogenic impotence was suspected at artificial penile erection test, duplex ultrasound sonography and/or dynamic ifusion cavernosometry and cavernosography were carried out. In case of suspected
neurogenic impotence, BCRL and Somato sensory evoked potential tests were conducted, and confirmed neurogenic impotence were excluded in this study. Forty four patients taking trazodone were divided into 31 psychogenic impotence and 13 mild
vasculogenic
impotence with psychogenic components. Trazdone was administered orally 50 mg each 3 times a day for 2-8 weeks. Based on the response to medication, increase in erection quality and frequency was regraded as positive, and no change in quality or
deterioration as negative response. Among 31 patients with psychogenic impotence, 15 patients (48%) showed positive response and 16 patients (52%) negative response. Of 13 patients (30%) with vasculogenic impotence with psychogenic components, 2
patients (15%) showed positive and 11 patients (85%) negative response. As side effect of drug, 15 patients complained mild drowsiness. Taking account into placebo effect, these results indicate that a prospective, randomizes and placebo
controlled
drug
trials will be needed.
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