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Trazodon — ein Antidepressivum mit prosexuellen Eigenschaften

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Der Urologe B

Zusammenfassung

Sexuelle Funktionsstörungen sind sehr häufig. Zur Behandlung der männlichen Impotenz organischer und zunehmend auch nicht-organischer Genese dient überwiegend die Schwellkörper-Injektion. Die Möglichkeiten der Therapie der abgeschwächten weiblichen Libido sind begrenzt. Psychopharmaka und so auch Antidepressiva verursachen häufig sexuelle Funktionsstörungen, wobei weit überwiegend nur der männlichen Sexualität Aufmerksamkeit gewidmet wurde. Trazodon ist ein Antidepressivum der zweiten Generation, in 43 Ländern registriert und in Deutschland seit 1977 unter dem Namen Thombran im Handel. Im Gegensatz zu anderen Antidepressiva scheint Trazodon bei organisch bedingter wie auch bei psychogener Impotenz Libido und erektile Potenz zu fördern. Einzelfallberichte weisen darauf hin, daß Trazodon auch eine abgeschwächte weibliche Libido positiv beeinflussen kann. Verantwortlich ist u. a. eine antialphal-adrenerg vermittelte verzögerte Detumeszenz des Schwellkörpers, Einiges spricht für zusätzliche zentralnervöse Mechanismen, zu denen auch eine anti-alpha2-adrenerge und antiserotonerge Komponente beitragen mag. Die bisherigen klinischen Befunde lassen einen Behandlungsversuch mit Trazodon bei erektiler Dysfunktion sinnvoll erscheinen. Auch wenn die Substanz speziell in dieser Indikation noch nicht zugelassen ist, ermöglicht die ärztliche Therapiefreiheit unter Berücksichtigung der vorliegenden Literatur und einer individuellen Nutzen-Risiko-Abwägung den Einsatz in der Urologie. Die prosexuelle Wirkung tritt im Gegensatz zur antidepressiven Wirkung bereits bei relativ niedrigen Tagesdosen von 50 bis 150 mg und auch schon innerhalb Stunden bis Tagen ein. Häufigste Nebenwirkung ist Müdigkeit infolge der sedierenden Eigenschaft von Trazodon, weshalb die Substanz abends verabreicht werden sollte. Als ernste, aber aüßerst seltene Komplikation (1:10000) muß an einen Priapismus gedacht werden, wobei dieses Problem unter der alternativen SKAT-Therapie deutlich häufiger zu erwarten ist.

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Authors and Affiliations

  1. Zentrum für Psychiatrie, Universitätskliniken, Universitätskliniken Frankfurt/Main, Heinrich-Hoffman-Straße 10, D-60528, Frankfurt/Main

    J. Fritze

  2. Urologische Klinik, Städtische Kliniken Dortmund, German

    M. Witkowski

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  1. J. Fritze
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  2. M. Witkowski
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Fritze, J., Witkowski, M. Trazodon — ein Antidepressivum mit prosexuellen Eigenschaften. Der Urologe B 37, 52–56 (1997). https://doi.org/10.1007/s001310050062

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