CNS drugs and antiepileptics: trazodone priapism: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · CNS drugs and antiepileptics: trazodone priapism

Sample item

A 45-year-old man takes a low-dose sedating antidepressant at night for insomnia. He presents with a painful erection lasting five hours without sexual stimulation. Which drug is most likely responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Trazodone

Trazodone is a classic cause of priapism, attributed to its alpha-1 adrenergic blockade. Patients should be warned to seek urgent care for an erection lasting more than four hours, because untreated priapism can cause permanent erectile dysfunction.

Option by option

  • A. Bupropion

    Bupropion mainly causes insomnia, tremor and seizures and does not have sedating alpha-1 blockade.

  • B. Trazodone (correct)

    Correct. Trazodone blocks alpha-1 receptors and is the antidepressant most linked with priapism.

  • C. Mirtazapine

    Mirtazapine causes sedation and weight gain, and priapism is only a rare report.

  • D. Sertraline

    Sertraline more often causes delayed ejaculation and reduced libido than priapism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Trazodone. Trazodone is a classic cause of priapism, attributed to its alpha-1 adrenergic blockade.

Why is "Bupropion" not the answer?

Bupropion mainly causes insomnia, tremor and seizures and does not have sedating alpha-1 blockade.

Why is "Mirtazapine" not the answer?

Mirtazapine causes sedation and weight gain, and priapism is only a rare report.

Why is "Sertraline" not the answer?

Sertraline more often causes delayed ejaculation and reduced libido than priapism.

What concept does this question test?

It tests CNS drugs and antiepileptics: trazodone priapism in Pharmacology. Patients should be warned to seek urgent care for an erection lasting more than four hours, because untreated priapism can cause permanent erectile dysfunction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study CNS drugs and antiepileptics: trazodone priapism?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.