- 期刊
The Role of Trazodone in the Treatment of Erectile Dysfunction
Trazodone治療性功能障礙之角色
摘要
14位性功能障礙病人以陰莖硬度檢測儀觀察Trazodone對夜間陰莖勃起之影響。對於全部勃起時間，睡眠時勃起所佔的比例及最大勃起硬度，Trazodone均有顯著促進作用，而對陰莖圓周之增加則無影響。在全部勃起時間的增加最明顯，可由治療前平均38.4分鐘延長治療後平均96.3分鐘。而其中值得注意的是有5位病人，治療後每次勃起時間超過1個小時，此現象在正常生理下是罕見的。 以Trazodone ( 100至200毫克）對35位明顯器質性陽萎病人施行5週之單盲試驗，結果以問卷判斷。Trazodone治療組68.6%的改善率，相對於安慰劑僅有11.4%改善。接受Tra-zodone治療後常見的副作用為頭暈、疲倦、口乾、嗜睡，常發生於接受治療的前幾天．不過經數日的使用或減量後往往會消失。在兔子海綿體平滑肌體外試驗方面，Trazodone能鬆弛外加新腎上腺素引起之收縮並且抑制電刺激交感神經末稍引起之收縮。Trazodone對陰莖勃起的效果在周邊是經由阿爾發腎上腺性接受器之拮抗作用，而中樞的作用則相當複雜，可能經由交感抑制作用，血清促進素激導或度巴明激導的機轉。陽萎病人不管其原因為心因性或器質性，往往會伴隨著憂鬱、焦慮，而Trazodone在各種抗憂鬱劑中是相當獨特的，它不但不會影響夜間勃起反而有促進之作用，而在本研究中對器質性陽萎病人亦有很好的治療效果，因此Trazodone在治療性功能障礙所扮演的角色是重要的。
關鍵字
無資料並列摘要
The effects of trazodone on the nocturnal penile erection were demonstrated in 14 impotent patients by Rigiscan recordings. Trazodone significantly increased the total erectile time, per cent of sleep with erection and maximum rigidity, while it had no effect on increment of tumescence size. Trazodone (150 mg to 200 mg) was administered to 35 clearly organic impotent patients in a 5-week single-blind design. Patients were evaluated by questionnaire. The study showed an improvement in 68.6 per cent of the patients receiving trazodone versus 11.4 per cent receiving placebo. In vitro, trazodone could relax rabbit corporeal smooth muscle contractions induced by exogenous norepinephrine and inhibit contractions elicited by transmural electrical stimulation of adrenergic nerve endings. The effects of trazodone on penile erection may be due to a peripheral alpha adrenoceptor antagonism and central unknown mechanism. We conclude that trazodone may prove an effective treatment for impotent patients.