Trazodone and ejaculatory inhibition

Sexual adverse effects are common with psychotropics. Rational polypharmacy may confound etiology. This case report describes development of ejaculatory inhibition in a male patient with co-morbid psychiatric diagnoses treated with fluoxetine, divalproex sodium, lamotrigine, trazodone, and clonazepam. Detailed psychotropic history with time-line of adverse effect onset implicated trazodone. Within 48 hours of trazodone discontinuation, ejaculatory inhibition was resolved. Clinicians should be aware that trazodone may cause ejaculatory inhibition, understand that determination of sexual adverse effects necessitates directed and periodic questioning as these symptoms may increase in severity over time, and appreciate that religious patients may find discussing this issue difficult.