When you wind up in the emergency room, do tell your doctor about every medicine that you are taking. Case in point, a recent medical journal report I found while researching a widely used psychiatric drug.
WARNING: The included link contains graphic medical photographs that may not be safe for work.
“Penile Amputation After Trazodone-Induced Priapism: A Case Report,” was published in the Primary Care Companion to The Journal of Clinical Psychiatry this year, and recounts the case of a 35-year-old man who was prescribed trazodone, an antidepressant that predates Prozac and Paxil and is still the #12 most-used psychiatric drug, by a psychiatrist to treat sleep problems. The article was written by doctors at hospitals in Germany and Belgium.
This man, who had a history of blood clots and was taking a blood thinner, developed priapism – the hours-long erection that advertisements for Cialis and Viagra warn about. The patient presented to the emergency room with an erection that had lasted 15 hours. The doctors successfully treated him with what is known as a Winter shunt, which is used to drain extra blood from the spongy tissues of the penis. The patient did not mention his trazodone use, and the doctors assumed that his priapism had been caused by a blood clot.
Ten days later the patient was re-admitted for a second case of priapism, this one lasting four hours. This time he did let the doctors know that he had not only been taking 150 milligrams of trazodone every night, he was also occasionally doubling the dose. Discontinuing the medicine would probably have prevented the second case of priapism. This time, the Winter shunt did not work, and blood clots did form in the man’s penis. Two days later, a dry necrosis appeared. After three weeks of treatment, amputation was performed.
The authors warn doctors to carefully monitor use of trazodone and other antidepressants in men who have clotting disorders. Also, those ads for erectile dysfunction drugs? Don’t complain about them. They should probably be even more explicit – and scarier.