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Effect of yohimbine-trazodone on psychogenic impotence: A randomized, double-blind, placebo-controlled study

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      Abstract

      Objectives.

      The aim of this study was to determine the effectiveness and safety of yohimbine and trazodone used together for the treatment of pure psychogenic impotence.

      Methods.

      Sixty-three patients who had psychogenic impotence diagnosed on the basis of sexual history, results of physical examination, laboratory analysis, polysomnographic recording of nocturnal erections, and dynamic color Doppler sonography of the cavernosal arteries were entered into a randomized, double-blind, placebo-controlled, partial crossover study comparing placebo with yohimbine (15 mg per day orally) and trazodone (50 mg per day orally) used together. Treatment consisted of two 8-week courses. Patients who initially received placebo for 8 weeks were then switched to the 2-drug combination for 8 weeks. Erectile function, ejaculation, interest in sex, and sexual thoughts were investigated at the end of drug treatment and at 3- and 6-month follow-up. For statistical analysis chi-square, McNemar, and Student's t test for unpaired data were used.

      Results.

      Fifty-five patients (87%) completed the whole treatment schedule. Positiveclinical results (complete and partial responses) were obtained in 39 (71 %) patients at the end of the drug treatment phase. These results were significantly better than those obtained with placebo (p < 0.01). Positive results were maintained in 32 (58%) and 31 (56%) patients at 3- and 6-month follow-up, respectively. Minor drug-related adverse effects occurred in 6 (11 %) of the patients in the yohimbine-trazodone group and in 2 (4%) in the placebo group.

      Conclusions.

      The combination of yohimbine and trazodone is a safe and effective firstlinetreatment for psychogenic impotence.
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      References

        • Krane R.J.
        • Goldstein I.
        • Saenz de Tejada I.
        Impotence.
        N Engl J Med. 1989; 321: 1648-1659
        • Smith A.D.
        Psychologic factors in the multidisciplinary evaluation and treatment of erectile dysfunction.
        Urol Clin North Am. 1988; 15: 41-51
        • LoPiccolo J.
        • Stock W.E.
        Treatment of sexual dysfunction.
        J Consult Clin Psychol. 1986; 54: 158-167
        • Reynolds B.S.
        Psychological treatment models and outcome results for erectile dysfunction: a critical review.
        Psychol Bull. 1977; 84: 1218-1238
        • Susset J.G.
        • Tessier C.D.
        • Wincze J.
        • Bansal S.
        • Malhotra C.
        • Schwacha M.G.
        Effect of yohimbine hydrochloride, onerectile impotence: a double-blind study.
        J Urol. 1989; 141: 1360-1363
        • Foreman M.M.
        • Wernicke J.F.
        Approaches for the development of oral drug therapies for erectile dysfunction.
        Semin Urol. 1990; 8: 107-112
        • Riley A.J.
        • Goodman R.E.
        • Kellett J.M.
        • Orr R.
        Double blind trial of yohimbine hydrochloride in the treatment treatment of erection inadequacy.
        Sex Marit Ther. 1989; 4: 17-26
        • Georgotas A.
        • Forsell T.L.
        • Mann J.J.
        • Kim M.
        • Gershon S.
        Trazodone hydrochloride: a wide spectrum antidepressant with a unique pharmacological profile. A review of its chemical effects, pharmacology, clinical efficacy, and toxicology.
        Pharmacotherapy. 1982; 2: 255-265
        • Szele F.G.
        • Murphy D.L.
        • Garrick N.A.
        Effects of fenfluramine, m-chlorophenylpiperazine, and other related agonists and antagonists on penile erections in non-human primates.
        Life Sci. 1988; 43: 1297-1303
        • Reid K.
        • Surridge D.H.
        • Morales A.
        • Condra M.
        • Harris C.
        • Owen J.
        • Fenemore J.
        Double-blind trial of yohimbine in treatment of psychogenic impotence.
        Lancet. 1987; 2: 421-423
        • Morales A.
        • Condra M.
        • Owen J.A.
        • Surridge D.H.
        • Fenemore J.
        • Harris C.
        Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial.
        J Urol. 1987; 137: 1168-1172
        • Saenz de Tejada I.
        • Ware J.C.
        • Blanco R.
        • Pittard J.T.
        • Nadig P.W.
        • Azadzoi K.M.
        • Krane R.J.
        • Goldstein I.
        Pathophysiology of prolonged penile erection associated with trazod.
        J Urol. 1991; 145: 60-64
        • Charney D.S.
        • Heninger G.R.
        Alpha-2-adrenergic and opiate receptor blockade. Synergistic effects on a anxiety in healthy subjects.
        Gen Psychiatry. 1986; 43: 1037-1041