Trazodone priapism mechanism

The association of priapism with trazodone is reviewed based on data reported to the Food and Drug Administration. The data suggest that priapism may be most likely to occur within the first 28 days of treatment and that the majority of cases occur with doses of 150 mg/day or less. All age groups appear to be vulnerable to this adverse effect Abstract To investigate the mechanism of drug-induced priapism, we gave the antipsychotic agent chlorpromazine and the antidepressant trazodone to 14 dogs by intravenous and intracorporeal injection. Bilateral intracorporeal pressure, blood flow within the internal pudendal artery, and systemic blood pressure were monitored In addition to the alpha1-adrenergic antagonism with which priapism is caused by, trazodone also inhibits the neuronal uptake of serotonin and is a histamine antagonist. Multiple case reports have established a connection between the use of a combination of trazodone and other antipsychotics with priapism occurrence -Trazodone, buproprion, fluoxetine, sertraline, lithium, clozapine, Sickle Cell Disease and Priapism Mechanism presumed to be stagnation of blood within the sinusoids of the corpora during erections and sickled erythrocytes obstructing venous outflow. Lifetime probability of a man with SCD developing ischemic priapism ranges from 29 To investigate the mechanism of drug-induced priapism, we gave the antipsychotic agent chlorpromazine and the antidepressant trazodone to 14 dogs by intravenous and intracorporeal injection. Bilateral intracorporeal pressure, blood flow within the internal pudendal artery, and systemic blood pressure were monitored

Priapism is characterised by a persistent erection that cannot be relieved by sexual intercourse or masturbation. Although priapism subsides spontaneously in a few days, impotence frequently follows. Both vascular and neural mechanisms are implicated in the pathophysiology of priapism, but it is not clear which initiates the process Our patient scored 4 (possible adverse reaction) on the Naranjo adverse drug reaction (ADR) probability scale. 10 We could not find a possible mechanism of priapism with combined use of trazodone and mirtazapine. Also, the prevalence of patients tolerating combination treatment of trazodone and mirtazapine without evidence of priapism is not. This post will summarize Trazodone's mechanism of action and answer the following two questions: What dose of Trazodone is effective for major depression disorder Trazodone and Risk of Priapism. This chapter will be summarized in following sections: Priapism: definition and types Trazodone is a relatively weak but specific inhibitor of the serotonin reuptake transporter with minimal affinity for NE or dopamine reuptake. Trazodone also inhibits 5-HT1A, 5-HT 1C, and 5-HT 2 receptors. It has essentially no affinity for M 1 receptors, but it does have moderate H 1 receptor antagonism Trazodone is a triazolopyridine derivative that works as a postsynaptic 5-HT2a antagonist with alpha-adrenergic antagonist effects. In some patients, this antagonism effect at alpha-adrenergic receptors may trigger the onset of prolonged painful penile erections causing priapism

Mechanisms of sickle cell disease associated priapism may involve dysfunctional nitric oxide synthase and ROCK signaling, and increased oxidative stress associated with NADPH oxidase mediated signaling [21]. Priapism resulting from metastatic or regional infiltration is rare and usually reflects an infiltrative process [22] The complication of priapism is suggested to result from its alpha-blocker mechanism, where the corpus is a combined mixture of alpha1- and alpha2-adrenoceptors To the Editor: Painful persisting penile erection (priapism) is a rare but very serious side effect that can occur with antidepressants in general 1 - 4 and with trazodone in particular. 5, 6 Trazodone is a very commonly prescribed antidepressant. 7, 8 Although clear evidence is lacking, trazodone is often administered, in clinical practice, to treat disordered sleep as in insomnia (eg, see Mendelson 8)

Trazodone and priapism - PubMe

Cases of priapism (painful erections greater than 6 hours in duration) have been reported in men receiving Trazodone hydrochloride tablets. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue A note on priapism. Trazodone has been associated with the occurrence of priapism, a painful and persistent incidence of penile tissue erection that is unrelievable and can cause permanent neurological damage if left untreated. Patients must be advised to seek immediate medical attention if priapism is suspected. 15,21. Mechanism of actio

Higher doses are required for an antidepressant effect. The occupancy of specific receptors at therapeutic doses also explains peculiar side effects reported by patients treated with trazodone (e.g. dry-mouth, hypotension and priapism) Mechanism of Action Trazodone is an antidepressant that works by inhibiting both serotonin transporter and serotonin type 2 receptors. It is a triazolopyridine derivative. Trazodone inhibits the reuptake of serotonin and blocks the histamine and alpha-1-adrenergic receptors

The National Library of Medicine (NLM), on the NIH campus in Bethesda, Maryland, is the world's largest biomedical library and the developer of electronic information services that delivers data to millions of scientists, health professionals and members of the public around the globe, every day A relatively rare side effect associated with trazodone is priapism, likely due to its antagonism at α-adrenergic receptors. More than 200 cases have been reported, and the manufacturer estimated that the incidence of any abnormal erectile function is about one in 6,000 male patients treated with trazodone

Definition Trazodone is an older antidepressant medication that has a mixed mechanism of action affecting multiple neurotransmitter systems. It is often used in adults as an adjunctive treatment for depression, particularly to aid with sleep. It has not been evaluated in children or adults with autism Welcome new interns and residents across the globe! Now is a perfect time to join our contributor community and help make acute medical knowledge open and readily available to all Although, this case suggests that there may be a close relationship between trazodone, priapism, drugs and alcohol, the exact mechanism is not clear. Priapism results from decreased venous outflow from the corpora cavernosa of the penis. There are wide variations in the interval between initiation of trazodone use and the onset of priapism Trazodone can be used to treat major depressive disorder by modulating serotonin signaling in the brain. It can also be used off-label to treat insomnia due to its strong sedative effects. A major adverse effect of trazodone use is priapism, which is a painful erection lasting more than four hours independent of sexual arousal Trazodone oral tablets are commonly used off label to treat short-term anxieties or as an adjunctive treatment for behavioral disorders in dogs and cats. Side effects may include sedation, behavior changes, vomiting, and priapism. Patients with heart, kidney, or liver disease or closed angle glaucoma should use this medication with caution

Priapism Induced by Chlorpromazine and Trazodone

Trazodone should be used with caution in men who have conditions that might predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), or in men with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease) inhibitor^.^-^^-^' The mechanism by which phenothiazines induce pria- pism is unclear; although it is known that they are potent central dopamine receptor blockers and also possess anticholinergic and a-adrenergic- blocking proper tie^.^^ Trazodone has been associated with priapism, oc- curring in 1 per 10,000-20,000 pa Trazodone should be used with caution to reduce the risk of priapism in patients affected by multiple myeloma, sickle cell anaemia, hypercoagulable states, leukaemia, autonomic nervous system dysfunctions, and anatomical deformation of the penis (e.g., Peyronie's disease, angulation, or cavernosal fibrosis), or in combination with SSRIs. TRAZODONE HYDROCHLORIDE TABLETS safely and effectively. Priapism: Cases of painful and prolonged penile erections and priapism have been reported. Immediate medical attention should be sought if signs 12.1 Mechanism of Action 12.2 Pharmacodynamics 12.3 Pharmacokinetics 13 NONCLINICAL TOXICOLOGY 14 CLINICAL STUDIE studies performed to understand the mechanism of action of trazodone and other antipsychotics, the most widely ac-cepted mechanism involves a decrease in local sympathetic tone with respect to the local parasympathetic tone [14]. In addition to the alpha1-adrenergic antagonism with which priapism is caused by, trazodone also inhibits the neurona

Trazodone is an anti-depressant with the uncommon side-effect of priapism in approximately 1/10,000-20,000 users. It has been used for the treatment of erectile dysfunction without any clear evidence that it is truly effective Trazodone hydrochloride tablets should be used with caution in men who have conditions that might predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), or in men with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease) Case Report Loxapine-Induced Priapism: A Case Report and Review of the Literature on Antipsychotic-Induced Priapism Alexandra L. Dodd ,1 Sunny Patel,1 and David C. Fipps 2 1University of South Carolina, Greenville, Prisma Health-Upstate, 701 Grove Rd, Greenville, SC 29605, USA 2Mayo Clinic, 200 1st St SW Rochester, MN 55902, USA Correspondence should be addressed to Alexandra L. Dodd. Priapism, a relatively uncommon disorder, is a medical emergency. Although not all forms of priapism require immediate intervention, ischemic priapism is associated with progressive fibrosis of the cavernosal tissues and erectile dysfunction. 1, 2 Thus, all patients with priapism should be evaluated emergently in order to intervene as early as possible in those patients with ischemic priapism Increased libido in three men treated with trazodone - PubMed. Two sexual side effects associated with trazodone have been reported: priapism in men and increased libido in women. This report describes three depressed men who had increased libido while receiving trazodone. Possible mechanisms are suggested

Trazodone is metabolized by CYP3A4 and CYP2D6, leaving the potential for increased levels of trazodone when it is combined with enzyme-inhibiting protease inhibitors or NNRTIs, which can cause priapism in high doses [4, 7]. Bupropion which is commonly used in depression is inhibitor of CYP2B6 that can also potentially increase the level of. Immediate release: Initial: 50 mg twice daily; may increase in increments of 50 mg/day every 3 to 7 days to a target dose of 75 to 150 mg twice daily. Thereafter may further increase by 50 to 100 mg/day every 2 to 4 weeks based on response and tolerability; usual dosage range 200 to 400 mg/day; maximum 600 mg/day The side effects of trazodone may be a concern and include symptoms such as orthostatic hypotention, priapism (painful, lasting erections), and cardiac arrhythmias. These side effects may be enough of a warning that some users want to discontinue the medication. Abruptly stopping, however, may trigger a discontinuation syndrome, with some. It is hoped by decreasing the dosage of Trazodone to 25 mg, the priapism will diminish, and the patient will continue taking the Trazodone and see improvement in his sleep. Research shows that a lower dose of Trazodone can still be effective and even cause fewer side effects due to the drug's short half-life (Abdelmesseh et al., 2017)

known to cause priapism.1 Trazodone, an atypical antidepres-sant and hypnotic, is the psychiatric medication most com-monly associated with ischemic priapism with an incidence of 1:6000.4 The most likely mechanism by which this occurs is alpha-adrenergic blockage in the corpora cavernosa leading toaparasympathetic-mediatedarteriodilationaswell. Trazodone-induced priapism 24 (prolonged erection in the absence of sexual stimulation). Priapism occurs very rarely -- in 0.1-0.01% of men who take this medication. Frequently causes headache, sometimes quite severe 28; Mechanism of action. Trazodone acts as a dual 5-HT agonist and 5-HT reuptake inhibitor Mechanism The mechanism of this interaction is not clear. However, taking into account that LSD causes a rise in serotonin levels in the brain, it is hypothesized that there is increased stimulation of 5-HT1 and 5-HT2 receptors when re-uptake of serotonin is blocked. Serotonin reuptake blockade is part of the mechanism of action of trazodone

Initially, priapism was only noted to be associated with the use of the more typical first generation antipsychotic medications and trazodone, but now there have been some reports of the newer atypical antipsychotics causing priapism as well . Trazodone is U.S. Food and Drug Administration-approved for treating major depressive disorder, but it. Serotonin antagonist and reuptake inhibitors tend to have fewer side effects than some earlier generation antidepressants such as tricyclics and monoamine oxidase inhibitors (MAOIs). 3. That said, SARIs can produce some side effects. Commonly experienced side effects of trazodone are: 3,4,7. Headache

Mechanisms of action for neuroprotection identified from laboratory and clinical research: The primary mechanism of action by which trazodone was thought to benefit Alzheimer's patients is through its anxiolytic, anti-depressant, and sedating effects. There is insufficient evidence of trazodone's benefits for primary insomnia In fact, trazodone ability to improve sleep has been considered one important augment mechanism to improve the efficacy of other antidepressants . The alternatives of increasing paroxetine or mirtazapine dosage could also resolve depressive symptoms but require the prescription of an additional hypnotic benzodiazepine or sleep-inducer (at least.

Pretreatment screening and counseling on prolonged

  1. e and serotonin. Many experts believe that an imbalance among the different neurotransmitters is the cause of depression
  2. Trazodone and Xanax are very different in their chemical structure and their mechanisms of action in the body. However, trazodone also became popular with people who are using Xanax as a recreational drug, thinking that trazodone will provide the same effects. Another known side effect of trazodone is priapism. This condition is.
  3. Rare cases of priapism (painful erections greater than 6 hours in duration) were reported in men receiving trazodone. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. The mechanism is uncertain. Clinically, the flavonoids of ginkgo do not usually produce significant sedative effects. However, the.
  4. Priapism (a persistent painful erection) 3,12,14,17; Visual hallucinations 14; The mechanism of action of trazodone is thought to involve preventing serotonin and likely other neurotransmitters from binding to the receptors that these would normally bind to, connect with, or be attracted to..
  5. Priapism is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended. There are three types: ischemic (low-flow), nonischemic (high-flow), and recurrent ischemic (intermittent). Most cases are ischemic. Ischemic priapism is generally painful while nonischemic priapism is not. In ischemic priapism, most of the penis is hard; however, the.
  6. g effect of the medication. Priapism (painful and persistent penile erection

Drug-Induced Priapism Its Aetiology, Incidence and

Trazodone is a multifunctional prescription drug approved by the U.S. Food and Drug Administration for the treatment of depression. 1 It also has many off-label uses and has been successfully utilized to treat conditions such as insomnia, fibromyalgia, diabetic nerve pain, panic and anxiety disorders, eating disorders, and agitation in people. What is trazodone? Trazodone was developed in Italy in the 1960s as an antidepressant medication. Due to negative side effects associated with the drug early on—including dizziness, fainting, irregular heartbeat (and in rare cases, priapism in men)—the antidepressant wasn't widely favored in the medical community Trazodone is a second generation antidepressant and a multifunctional drug. Multifunctional drugs have more than one therapeutic mechanism. Trazodone's functions depend on the dosage, with low doses providing hypnotic actions and higher doses turning it into an antidepressant. 1 Trazodone is one of the go-to drugs for treating major depressive disorder and is a schedule IV drug like Xanax. Priapism (including clitoral priapism or clitorism) has been reported in a number of patients receiving trazodone. Priapism occasionally results in permanent impairment of erectile function or impotence. Patients should be warned of the possibility and to discontinue the drug at once and consult with the physician if this reaction occurs. How Safe Is Trazodone? Trazodone works by affecting chemical messengers in the brain, including serotonin and dopamine; however, its precise mechanism of action isn't fully understood. 8 Trazodone's primary use is for the treatment of depression. 7 As previously mentioned, trazodone is also commonly given to patients for insomnia management because one of its side effects is drowsiness.

Trazodone is an 'atypical antidepressant' that affects the brain differently than more common antidepressants. Trazodone belongs to a class of drugs called selective serotonin re-uptake inhibitors (SSRIs), which are antidepressant medications block serotonin signaling in specific receptors in the brain The most commonly noted side effects associated with nefazodone are nausea, dizziness, insomnia, agitation, tiredness, dry mouth, constipation, lightheadedness, blurred vision, and confusion.Rarely, nefazodone is associated with priapism or prolonged penile erection. Compared with trazodone, nefazodone has a lesser risk of priapism (prolonged penile erection)

erect trombone: trazodone can cause priapism - emergency, be cautious with patients predisposed to priapism: MM, sickle cell anemia fainting: trazodone can cause orthostatic hypotension sleeping players: trazodone can cause sedation - treat insomni A painful, persistent erection (priapism) is a rare but severe side effect of most antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). Research reveals that priapism is reported in about 79 percent of causes of psychotic-drug-induced prolonged erections with trazodone prescription (Hoffmann et al., 2010)

Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. The various manufacturers claim that the antidepressant activity becomes active in the first week of therapy. Trazodone has less prominent anticholinergic (dry mouth, constipation, tachycardia) and adrenolytic (hypotension, male sexual. Priapism, including cases resulting in permanent dysfunction, has occurred with the use of trazodone. Not recommended for use in a patient during the acute recovery phase of MI. May cause sedation, resulting in impaired performance of tasks requiring alertness (ie, operating machinery or driving)

As long as it isn't an extended-release formulation, Yes, trazodone can be cut in half! Fear not. Anecdotal evidence: I only ever took half of my prescribed trazodone dose, which involved cutting the pill (tablet) in half. Generally, unless a a ta.. The mechanism of antidepressant action is not fully understood, but suspected to be related to its potentiation Decreased trazodone concentrations and decreased efficacy (Monitor Trazodone levels) DI: Fluoxetine, linezolid, paroxetine, venlafaxine priapism, prolonged QT, serotonin syndrome, suicidal thoughts, torsades de pointes Trazodone priapism. Vertical discontinuities trazodone priapism were detected in several panels trazodone 15 0mg street value in the published article. Vertical discontinuities were detected in several panels in this article, including panels of Figs 2C, 4F, 4G and 5B Lithium's mechanism of action is incompletely understood but thought to interact with signal transduction pathways (e.g., IP3 pathway) Trazodone carries a risk of priapism traza-BONE Trazodone has minimal anticholinergic activity and is a good choice for elderly patients (but there is a risk for falls due to alpha 1 antagonism and. Plaintiff, a California resident, was prescribed and ingested generic trazodone for insomnia. He alleges that the trazodone caused him to experience priapism, a prolonged penile erection, lasting over 24 hours and he is now impotent. Id. at *1. Plaintiff brought claims for strict liability, negligence, breach of implied and express warranties.

Trazodone was first developed in Italy in the 1960s, and became available for use in the Mechanism of action Trazodone is classified as a serotonin antagonist/reuptake inhibitor (SARI). At low to A rare side effect in human males is priapism, occurring at a rate of approximately 1/10,000. This side effect has not been reported in dogs. Priapism defined as persistent, painful and prolonged penile erection, was previously thought to be associated only with the use of the older, conventional first generation or typical antipsychotic medications as well as some other medications, notably, trazodone. The mechanism of priapism associated with antipsychotics is not clear but is thought to be related to α-adrenergic blockage that. placebo.11 Trazodone has been associated with priapism. Duloxetine causes less sexual dysfunction than paroxetine, but more than placebo.12 Anti-epileptics: hyposexuality is common in epilepsy; however, anti-epileptic medications worsen the situation, usually via hor-monal effects on the hypothalamic-pituitary-adrenal (HPA) axis Treatment with the antidepressant trazodone has been associated with the occurrence of prolonged penile erection and priapism. To evaluate the effect of trazodone on erection we monitored the periodic physiological sleep-related erections in 6 healthy volunteers in a double-blind crossover study comparing the effect of trazodone, trimipramine. 4. Tricyclic antidepressants such as Trazodone and benzodiazepines. Antipsychotic medications such as phenothiazines and risperidone, as well as illicit drugs such as cocaine and marijuana can result in priapism. 5. Hematological disorders like sickle cell disease, thalassemia, polycythemia, etc. 6

Priapism Lasting 19 Hours With Combined Use of Trazodone

Rarely, trazodone can cause priapism (between 1 in 1,000 and 1 in 10,000), and increased libido has been reported in clinical practice, which is one of the primary reasons it has been considered effective in the treatment of sexual dysfunction. 60,61 Gastric distress, nausea, vomiting, and decreased appetite are rarely reported as side effects. Priapism is a rare but serious adverse effect of psychotropic drugs resulting from their peripheral alpha-adrenoreceptor blocking action. Two patients developed this during treatment with oral phenothiazines: one was treated surgically with a venous shunt, and the second case resolved after intracavernosal injection of an alpha-adrenoreceptor stimulating drug

Trazodone: Dose, Mechanism & Clinical Response

Priapism is a disorder in which the penis maintains a prolonged erection in the absence of appropriate stimulation. Three broad categories exist for this disease: ischemic, nonischemic, and recurrent ischemic. Ischemic causes of priapism are a true emergency and require prompt intervention to prevent damage to the penis, which can progress to. 7,438. Location. another galaxy. Mar 10, 2005. #2. According to rxlist.com, trazodone is freely soluble in water. So snorting it would cause the drug to hit you harder and faster. Since trazodone is a more sedating SSRI maybe that explains why they got fucked up. They are still dumb for doing it though IMO An overdose can be fatal when trazodone is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium). Overdose symptoms may include extreme drowsiness, vomiting , penis erection that is painful or prolonged, fast or pounding heartbeat, seizure (black-out or convulsions), or breathing that slows or stops

Trazodone - an overview ScienceDirect Topic

It is felt that priapism may involve a different physiologic mechanism than that for normal penile erection. In the state of priapism the viscosity of the blood engorging the penile tissue increases abnormally (cf: The Merck Manual, 14th Edition (1982) page 1602). While the incidence of trazodone-associated priapism or undesired abnormal. Mechanism of erection 9. Pathophysiology of priapism • These events occur in both normal and pathologic erections. • The pathophysiology of priapism involves failure of detumescence and is the result of the underregulation of arterial inflow (ie, high flow) or, more commonly, the failure of venous outflow (ie, low flow)

Is Priapism a Side Effect of Trazodone? - ePainAssis

Priapism: Cases of painful and prolonged penile erections and priapism have been reported. Immediate medical attention should be sought if signs and symptoms of prolonged penile erections or priapism are observed (5.6). • Activation of Mania or Hypomania: Screen for bipolar disorder and monitor for mania or hypomania (5. 7). Trazodone is approved by the Food and Drug Administration (FDA) for use in major depressive disorder 3 4. It is sometimes prescribed off-label for other purposes, such as insomnia or anxiety. Trazodone is a generally safe medication, but it has several potential side effects that can be dangerous 1 2 3. Blood Pressure and Heart Effect Trazodone is contraindicated in patients hypersensitive to trazodone. Warnings Trazodone has been associated with the occurrence of priapism. In approximately 1/3 of the cases reported, surgical intervention was required and, in a portion of these cases, permanent impairment of erectile function or impotence resulted Trazodone is an FDA-approved treatment for depression, anxiety, and some forms of insomnia. It is also sometimes used off-label to relieve certain symptoms of bulimia, dementia, and alcoholism. Read on to learn more about the various medical uses, mechanisms, and potential side-effects of this drug

Emergent Treatment of Ischemic Priapism to Avoid Sexual

The mechanism of trazodone's antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS. Trazodone is both a selective serotonin reuptake inhibitor ( SSRI ) and a 5HT2 receptor antagonist and the net result of this action on serotonergic transmission and its role in. Trazodone is an N-arylpiperazine in which one nitrogen is substituted by a 3-chlorophenyl group, while the other is substituted by a 3-(3-oxo[1,2,4]triazolo[4,3-a]pyridin-2(3H)-yl)propyl group. It has a role as an antidepressant, a sedative, an adrenergic antagonist, a H1-receptor antagonist, a serotonin uptake inhibitor and an anxiolytic drug. It is a N-alkylpiperazine, a N-arylpiperazine, a. The term priapism is derived from Priapus, the Greek god of fertility, gardening, and lust who is depicted with a massive phallus [ 1 ]. Priapism is defined as a persistent erection of the penis or clitoris that is not associated with sexual stimulation or desire. The focus of this topic will be penile priapism

DepressionPSSD Collaborative Research • View topic - Recovered ForumPriapism

Mechanism of action [edit | edit source] Trazodone is a serotonin reuptake inhibitor and is also a 5-HT 2 receptor antagonist. However, in contrast to the selective serotonin reuptake inhibitors such as fluoxetine (Prozac®), trazodone's antidepressant effects may be due to its antagonistic effect at the 5-HT 2 receptor site (PMID 1365657) Constipation. continuing ringing or buzzing or other unexplained noise in the ears. diarrhea. hearing loss. muscle aches or pains. weight loss. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects Female priapism is a very rare condition. The physiologic mechanism of priapism involves impaired outflow of blood from the corpora cavernosa from either direct venous obstruction or failure of the alpha-adrenergic relaxation system [3]. This can lead to severe engorgement, swelling, and, in severe cases, thrombosis and fibrosis • Priapism: Has occurred. Warn male patients of this risk and how/when to • Hyponatremia: Can occur in association with SIADH (5.10). • Potential for Cognitive and Motor Impairment: Has potential to impair judgment, thinking, and motor skills. Advise patients to use caution when operating machinery (5.11) Trazodone is rapidly absorbed from the gastro-intestinal tract and extensively metabolised. Paths of metabolism of trazodone include n-oxidation and hydroxylation. The metabolic m-chlorophenylpiperazine is active. Trazodone is excreted in the urine almost entirely in the form of its metabolites, either in free or in conjugated form