trazadone for performance anxiety question

[ldhw]

I have been reading old posts. In one Hawk mentions taking trazadone to increase nocturnal erections. Though I dont  technically suffer from classic ed and I do have nocturnal erections I have difficulty relaxing enough with the wife. Its probably performance anxiety from past failures for which the cause has been fixed. Do you think trazadone might help me or does it only help with nocturnal erections?

[Skjaldborg]

You might want to try some drug-free methods to help with performance anxiety. Initiate sexual activities with your wife that are not penis focused but rather emphasize her enjoyment, i.e. massages, oral sex, etc. Do this with the mutual understanding that no penile intercourse is going to take place, even if you achieve a suitable erection. If you are comfortable with it, have her touch you even if you are not erect. Be vocal and encouraging about each other's bodies and get used to enjoying touch without the pressure to perform. Have fun, keep it light and try doing this on a regular basis. When you become comfortable with that, start doing so with the option of intercourse but not to the point of orgasm. Slowly work up to intercourse being the "main attraction."

Good luck!

Skjald

[ldhw]

Good suggestions for sure  Skjaldborg. We do some of that for sure its just hard to get in the mood right now. We have alot of external stress in our lives right now, makes it hard to quiet the mind when ya want to "get busy" in the bedroom.

[Hawk]

ldhw,

if you can get trazadone it is worth a try since it is cheap as dirt.  My experience is that it is not effective for erections when awake but others have reported some benefit.  One other possible side-effect from trazadone is that it can delay climax and ejaculation, not necessarily a bad thing.

My choice would be to work on the info Skjaldborg suggested and take about 1500 -2000 mg of l-arginine.

Hawk

[ldhw]

Thanks Hawk. I may see if I can get some just to give it a try. As to Arginine 1000mg twice daily is already among the seemingly thousands of supplements I already take, good suggestion though.

[Hawk]

ldhw,

Can you induce an erection on your own with no trouble?  If not, then you have a real ED issue going on.  Do not assume just because you have NTE's that all is well.  NTE's use different nerve pathways than stimulated erections whether physically stimulated with touch or psychologically stimulated.

[ldhw]

  No, I do have an issue, just not what most associate with classic ED. I used to have an internet porn addiction which I tackled a little over a year ago. My dopamine system is still not what it used to be due to the desensitizing effect that internet porn can bring about (caused by constant over stimulation of dopamine receptors). Though I can manualy stimulate an erection it is usually fairly weak. Until peyronies things were improving with the wife but I have alot of negative self talk that happens and if Im not completely in the moment with her I will have failure to launch.
 I just know that my issue isnt with the hardware its with my wiring (and not all the time). Thats why I thought that perhaps trazedone being an anti anxiety med with a possitive effect on dopamine levels might be useful to me. Especialy when you said it can have good results for some with mild ED.

[Hawk]

An erection is a complex occurrence.  While I am no expert on the physiology, I know enough to know that failure can take place anywhere from the nerve signals to arterial dilation, to venous leakage.  The arterial dilation requires adequate Nitric Oxide (NO) and adrenalin receptors on the cells will prevent the nitric oxide from attaching if adrenalin is present.  Stress, fear, and anxiety produce adrenalin, not to mention that they also just remove the stimulus that sends the nerve signals.

L-Arginine and PDE5 inhibitors effect the NO
A constriction band (cock Ring) prevents venous leakage
Only you can stop the adrenalin by controlling the stress of performance
There is no solution to nerve damage (other than VED). Nerve damage is rare unless there has been serious injury or surgery

You have to assess where in the process the erection is failing and deal with that aspect to fix the problem.  Also your assessment of porn addiction is dead on. Actual studies demonstrate that pornography triggers greater changes in dopamine in the brain than opiates.

Hawk
PS: No one has ever adequately explained how trazadone induces NTE's or the processes involved.

[ldhw]

It is indeed avery complex chain and one we are only now gaining any understanding of. Ive done alot of study on the subject and am pretty much certain my issues are mostly in the brain. I supplement a host of things like Arginine just to be safe but stress and anxiety coupled with comprimised pleasure pathways are my main issues. Pills like viagra dont do much for me, I take goat weed/maca twice daily just to cover bases but ultimately its in my head.

[MattFoley]

If anyone is considering Trazodone for nocturnal erections, you need to use 50 mg and no less and no more. I used Trazodone some time ago for sleep and I found that not only was I getting nocturnal erections, but I would also getting nocturnal emissions...multiple ones. It was a wild scene.

However this was before Peyronies Disease. I have not tried Trazodone since that time but may do so again soon.

Definitely take it early because it can make you feel groggy in the morning. It will knock you out cold.

I prefer taking Cialis at night instead.

[Hawk]

I totally disagree with MattFoley on Trazodone dosage.  I recommend 25 mg taken by cutting a 50 mg tablet in half and taken with a small snack (necessary for absorption).  My experience and the experience of most men I have known that experimented with different dosage is that 25 mg works as good or better than a larger dose.  It is a case where more is not better.

[MattFoley]

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Hawk, let me rephrase. 50 mg. works for me for night time erections but 25 mg. does very little. I would definitely say that the starting dosage should be 25 mg. and if nothing happens from there, the person can raise it. Beyond 50 mg will likely do nothing but knock you out cold.

I would caution that Trazodone is an anti-depressant and after long-term use, jumping off it will likely cause unpleasant side effects.

[Hawk]

Matt,

I have been told by 2 medical doctors that the dosage of Trazodone for depression ranges from 150 - 800 mg per day and that no such effect (beneficial or negative) will result from starting or stopping such a small dose.  (Especially 25 mg when taken a several times a week)

I also recommend only using it when you can get 7 or more hours sleep and not necessarily every night.  I use it a few times a week.

[MattFoley]

Hawk,

I completely agree that if someone chooses to use Trazodone for morning erections that it not be done everyday and that you should definitely take it when you can devote 7 or more hours of sleep.

However, I will tell you from personal experience, Trazodone is indeed addictive at even small doses, i.e. 25 mg. The biggest withdrawal side effect is sleeplessness. I've personally experienced it so I have to taper myself off of it slowly. It's no big deal but if you're anything like me, being addicted to a drug is not fun. Addiction is not realistic if you use it a few times a week at a small dose.

Lastly, this is a pretty easy drug to get your doctor to prescribe. Complaints of minor depression, sleeplessness, or just for the hell of it are probably good reasons to get the doctor to prescribe it.  

[MattFoley]

Anyone considering using Trazodone may wish to also consider Bupropion (Wellbutrin) as well.

Bupropion has shown improvement in sexual function in doses of at least 200 mg.

Please check out: http://en.wikipedia.org/wiki/Bupropion#Sexual_dysfunction

A prescription to this should be relatively easy to get considering I got one without even asking for it.

[Hawk]

While the Wellbutrin info is correct, the problem is that it is a clinical dose for depression whereas the dose of trazodone is far below a clinical dose and the owl is to just get the benefits of the side-effect.

[MattFoley]

Hawk, it really depends upon what you are trying to accomplish.

If you are trying to get nocturnal and morning erections, yes, Trazodone is good. But you have to take it at night otherwise you're going to fall asleep.

If you are trying to improve desire and the orgasm components of sexual function, then Bupropion is the best route. You take it in the morning and at night. It should not make you sleepy.

Another thing to keep in mind with Trazodone is that it raises Prolactin levels and that's not a good thing since elevated levels can be responsible for impotence and loss of libido.

The only reason I even touched Trazodone is because I was taking Chantix to break my smoking habit and Chantix makes me a bit wired so the Trazodone would knock me out. I'm still weaning myself off the Trazodone nice and slow so I don't get the sleeplessness related to withdrawals. And I've only been taking the Trazodone for a week. Imagine what long-term use would do and how long it would take me to get off it.

Whatever someone wants to do, they really need to talk to their doctor about these medicines. You can't play around with them since they both have side effects and withdrawal issues.

[Hawk]

I can report great results from trazadone for sleep and nte's taken at 25 mg with a snack about 3 days a week.  In truth I seldom need it for sleep.  Taken as reported, I have absolutely no negative side effects.  I can take it or leave it.  The only difference is the NTE's and I have taken it for 5 years.  Sometimes when my prescription runs out I go several weeks without it.

I actually think I get a better effect from it when I don't take it on several consecutive nights.

[MattFoley]

Ok, excellent.

As I mentioned, I get sleeplessness when I go off it abruptly.

Thank you for sharing your experience with me.