{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:04:26Z","timestamp":1774350266647,"version":"3.50.1"},"reference-count":12,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Ischemic priapism is a rare but serious adverse effect of trazodone, associated with a high risk of long-term sexual dysfunction. While its urological consequences are well described, psychiatric and psychosocial outcomes remain insufficiently explored. This study assessed psychiatric and sexual sequelae following trazodone-associated ischemic priapism and compared clinical characteristics with trazodone-treated patients without priapism. Materials and Methods: In this single-center observational study, 268 adult patients receiving trazodone were analyzed, including 17 patients with ischemic priapism and 251 controls. Data on episode duration and urological management were collected. Psychiatric status and sexual functioning were evaluated through structured clinician-led interviews informed by validated psychometric frameworks during hospitalization and at 1-, 3-, and 6-month follow-up. Nonparametric analyses and Spearman rank correlations were applied. Results: Patients with priapism were significantly older than controls (44.1 \u00b1 5.1 vs. 39.0 \u00b1 4.4 years; p &lt; 0.0001), while trazodone dose distribution did not differ between groups. The mean episode duration was 26.5 \u00b1 16 h (median 24 h). Older age and longer ischemic duration were independently associated with increased treatment intensity, whereas trazodone dose was not. Persistent depressive and anxiety symptoms and impaired sexual functioning were observed in a subset of patients during follow-up. Conclusions: Trazodone-associated ischemic priapism is not only an acute urological emergency but may also lead to sustained psychiatric and sexual sequelae. Interdisciplinary follow-up should be considered to address long-term psychosocial outcomes.<\/jats:p>","DOI":"10.3390\/medicina62040612","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:02:49Z","timestamp":1774339369000},"page":"612","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Observations of Psychiatric and Sexual Outcomes in Patients with Trazodone-Associated Ischemic Priapism"],"prefix":"10.3390","volume":"62","author":[{"given":"Hubert","family":"D\u0105browski","sequence":"first","affiliation":[{"name":"\u015awi\u0119tokrzyskie Center of Psychiatry in Morawica, Psychiatric Ward of the Mental Health Center in Kielce, 59 Kosuci\u0144skiego Street, 25-450 Kielce, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Z\u0105bkowski","sequence":"additional","affiliation":[{"name":"Department of General, Functional and Oncological Urology, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5583-3606","authenticated-orcid":false,"given":"Kamil","family":"Ciechan","sequence":"additional","affiliation":[{"name":"Warsaw Bar Association, 15\/16 \u017bytnia Street, 01-014 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Wajszczuk","sequence":"additional","affiliation":[{"name":"Department of General, Functional and Oncological Urology, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert Andrzej","family":"Krzepkowski","sequence":"additional","affiliation":[{"name":"Department of General, Functional and Oncological Urology, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8688-4171","authenticated-orcid":false,"given":"Tomasz W.","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Hemostasis and Thrombosis Program, Versiti Blood Research Institute, Milwaukee, WI 53226, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patryk","family":"Uciechowski","sequence":"additional","affiliation":[{"name":"Department of General, Functional and Oncological Urology, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Syry\u0142o","sequence":"additional","affiliation":[{"name":"Department of General, Functional and Oncological Urology, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1017\/S1092852900024020","article-title":"Mechanism of action of trazodone: A multifunctional drug","volume":"14","author":"Stahl","year":"2009","journal-title":"CNS Spectr."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zeiss, R., Malejko, K., Connemann, B., Gahr, M., Durner, V., and Graf, H. 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