Does trazodone help BPH? (+3 options)

This article will discuss whether trazodone is effective in managing benign prostatic hyperplasia (BPH) and its associated symptoms. It will also examine the mechanism of action of trazodone and how it may aid in enhancing the urination process for BPH patients. 

Additionally, the article will explore the findings of a clinical trial that investigated the effectiveness of trazodone in relieving BPH symptoms. Finally, potential side effects of using trazodone for BPH will be mentioned, along with treatment options available for managing this condition.

Does trazodone help BPH?

Trazodone can be used to help with some of the associated symptoms of benign prostatic hyperplasia (BPH). For example, it may help improve sleep quality in men who experience frequent awakenings during the night due to urinary urgency caused by BPH. 

However, trazodone is primarily used as an antidepressant, and while it may be prescribed off-label for certain conditions, such as insomnia or anxiety, it is not typically used for benign prostatic hyperplasia (BPH).

In some cases, it can be prescribed to treat certain consequences of BPH, such as sleep disturbances. People respond to medications differently, and not everyone with benign prostatic hyperplasia will benefit from administering trazodone.

It is important to consult with a doctor to determine whether trazodone is beneficial in your case. They will assess your medical history and consider any risks associated with the use of trazodone for BPH-related symptoms.

How can trazodone help BPH?

Benign prostatic hyperplasia (BPH) refers to the enlargement of the prostate gland, which can result in various urinary symptoms and sleep problems. To illustrate, the enlargement of the prostate gland causes compression on the bladder, creating resistance to the normal flow of urine [1].

As a result, individuals with BPH may experience increased urinary frequency, difficulties in completely emptying the bladder, and disrupted sleep patterns due to waking up multiple times to urinate during the night [1].

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI). It inhibits both the serotonin transporter and serotonin type 2 receptors. It also blocks histamine and alpha-1-adrenergic receptors [2].

Trazodone’s inhibition of serotonin type 2 receptors, adrenergic receptors, and histamine receptors leads to its sedating and hypnotic effects [2].

For patients with benign prostatic hyperplasia who may experience sleep disruptions due to frequent awakenings to urinate at night, trazodone can help enhance their sleep. Additionally, alpha blockers are commonly used to improve urine flow in BPH by relaxing the bladder neck muscles and prostate muscles.

This relaxation facilitates easier and more complete urination. Given that trazodone also has the ability to inhibit alpha-adrenergic receptors, it may potentially benefit BPH patients by enhancing their urination process.

What does research suggest?

In a clinical trial, a group of BPH patients took trazodone for 1 month, while another group took a placebo [3].

The patients taking trazodone experienced a significant increase in the average time of uninterrupted sleep, with an increase of 95 minutes compared to only 11 minutes in the placebo group [3].

Additionally, trazodone was found to increase the maximum urine flow rate by 3.7 ml/second, while the placebo actually resulted in a decrease [3].

Furthermore, the volume of urine remaining in the bladder after urination (known as the mean postvoiding residual urine) decreased by 41.3% after taking trazodone, whereas the placebo led to an increase in retained urine [3].

These changes in urine flow rate and postvoiding residual urine suggest that trazodone is highly effective in treating urinary retention in BPH patients. Moreover, the patients who took trazodone were able to excrete 74% more urine volume than before starting the medication [3].

These findings provide strong evidence that trazodone effectively enhances BPH symptoms and manifestations, such as nocturia and urinary retention.

What are the side effects of using trazodone for BPH?

If a doctor prescribes trazodone for BPH, it’s important to be aware of potential side effects. The side effects of trazodone include [4]:

• Drowsiness
• Hangover effect
• Dizziness
• Dry mouth
• Dry eyes
• Blurred vision
• Constipation
• Headache
• QT prolongation
• Decreased sex drive
• Acid reflux
• Nightmares
• Muscle ache 
• Night sweats

It is also important to mention that trazodone may also cause urinary side effects, such as frequent urination, in some people.

What are the effective treatment strategies for BPH?

There are various options available for managing benign prostatic hyperplasia (BPH) aside from trazodone [1].

Lifestyle modifications and watchful waiting

Weight loss, reducing caffeine intake, limiting fluid intake in the evening, and avoiding constipation are all recommended to reduce risk factors and improve lower urinary tract symptoms [4].

Medications

The following medications can be used to manage benign prostatic hyperplasia [4]:

• Alpha-blockers, such as Tamsulosin and Alfuzosin, work by relaxing the smooth muscle in the prostate stroma and bladder neck, which improves urine flow.

• 5 alpha-reductase inhibitors, like finasteride and dutasteride, block the synthesis of dihydrotestosterone (DHT), leading to a decrease in the prostate’s size.

• Antimuscarinic medications can help with overactive bladder and increased urgency in BPH, as they block muscarinic receptors on the detrusor muscle, preventing the contraction of smooth muscles and enhancing symptoms of overactive bladder.

Doctors usually prescribe a combination of an alpha-blocker and an alpha-reductase inhibitor to maximise improvements in urinary flow.

Surgery

When other treatments prove ineffective or specific conditions arise, surgery may be indicated for BPH. Examples of recommended procedures include transurethral incision of the prostate and transurethral resection of the prostate [4].

Surgery can only be considered if the patient is suffering from urinary retention unresponsive to the drugs mentioned previously, frequent urinary tract infections, bloody urine that’s unresponsive to treatment, bladder stones, and high-pressure chronic retention [4].

In conclusion, based on my research, I found that while trazodone is primarily used as an antidepressant, it can be used off-label to help with symptoms of benign prostatic hyperplasia (BPH), particularly sleep disturbances caused by urinary urgency. 

Research found that it can improve sleep quality and enhance the urination process in some individuals with BPH. However, I recommend consulting with a doctor to determine if trazodone is beneficial in your specific case, as people respond to medications differently.

Other options for managing BPH include lifestyle modifications, medications like alpha-blockers and 5-alpha-reductase inhibitors, and surgery in certain cases. Finally, I believe that you should consult with your doctor for the best approach for your BPH symptoms.

References