Pharmacology · Antiepileptics and CNS Drugs (Antipsychotics, Antidepressants, Sedatives)

A 45-year-old man on trazodone for insomnia develops a prolonged, painful erection lasting 4 hours. This adverse effect is due to blockade of which receptor?

  • A Muscarinic
  • B Alpha-2 adrenergic
  • C Alpha-1 adrenergic
  • D Dopamine D2
Correct answer: C. Alpha-1 adrenergic

Explanation

Trazodone is an alpha-1 adrenergic antagonist. Blockade of these receptors in the corpus cavernosum prevents detumescence, leading to priapism, a urological emergency. This effect is rare but well recognized and requires immediate intervention to prevent ischemic damage.

Reference: Katzung & Trevor's Pharmacology Examination and Board Review, 13th ed.

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