Trazodone: Difference between revisions
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MDElliottMD (talk | contribs) parser-claude: Trazodone MedTemplate refill, Top 300 stub upgrade |
Safety wave: priapism 4-hour emergency counseling (label + Warner 1987) |
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| legal = [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="trazodone-label" /> | | legal = [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="trazodone-label" /> | ||
| mechanism = <vote slug="trazodone-mech-claim">Combined strong 5-HT2A antagonism with weaker serotonin reuptake inhibition (the SARI class signature). At the low doses used for insomnia (25-100 mg), 5-HT2A antagonism, H1 antihistaminergic effect, and α1-adrenergic antagonism dominate, producing sedation; at antidepressant doses (≥150 mg) the SRI contribution adds. The active metabolite mCPP is a 5-HT2C agonist that may contribute to anxiogenesis in some patients.</vote> '''Priapism''' is a recognized rare adverse effect via α1 antagonism in penile vasculature and is the marquee counseling point for male patients<ref name="trazodone-label" />. | | mechanism = <vote slug="trazodone-mech-claim">Combined strong 5-HT2A antagonism with weaker serotonin reuptake inhibition (the SARI class signature). At the low doses used for insomnia (25-100 mg), 5-HT2A antagonism, H1 antihistaminergic effect, and α1-adrenergic antagonism dominate, producing sedation; at antidepressant doses (≥150 mg) the SRI contribution adds. The active metabolite mCPP is a 5-HT2C agonist that may contribute to anxiogenesis in some patients.</vote> '''Priapism''' is a recognized rare adverse effect via α1 antagonism in penile vasculature and is the marquee counseling point for male patients<ref name="trazodone-label" />. | ||
| counseling = Priapism is a recognized, uncommon adverse effect of trazodone, attributed to alpha-1 adrenergic antagonism in penile vasculature; cases requiring surgical intervention or resulting in permanent erectile dysfunction have been reported.<ref>Trazodone hydrochloride prescribing information, Warnings and Precautions (priapism).</ref> Patients should be counseled that a prolonged erection, generally one lasting more than 4 hours, or any painful erection unrelated to sexual activity, is a medical emergency requiring immediate care, because delayed treatment risks permanent damage.<ref>Warner MD, Peabody CA, Whiteford HA, Hollister LE. Trazodone and priapism. J Clin Psychiatry. 1987;48(6):244-245.</ref> | |||
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