The Four-Hour-Long Erection
Sometimes the side effects of antidepressant medications are funny. Sometimes...
My palms were sweating. My mouth was dry. The pain began. My anxiety kicked into overdrive. I was an hour into a prolonged erection.
My first foray into psychiatric medication came courtesy of a little drug called Trazodone. An SARI, and not the more commonly prescribed SSRI, Trazodone was my GP’s first guess at the trial and error that would be my mental healthcare. With any luck, he reasoned, it would address my insomnia too. I took care to read up on side effects, and the usual suspects were present:
nausea
vomiting
diarrhea
constipation
changes in appetite or weight
weakness or tiredness
nervousness
dizziness or lightheadedness
nightmares
muscle pain
dry mouth
rash
You know, the easy stuff. An increased risk of prolonged erections, though? Never seen that one before. Sounds unlikely, right? And would a prolonged erection really be a problem? Oh, and what’s this? Consumption of alcohol increases the risks of these side effects… I wouldn’t be dumb enough to drink on these meds, would I?
Shit got real after hour two. The pain, surprising and novel, increased. My mind was racing through every doomsday scenario like The Flash through the multiverse. I started to Google.
Trazodone would be my first, but far from my last antidepressant. Starting a new psychiatric medication is no joke, and comes with different consequences depending on the drug. I often lost the first few days; sometimes to confusion, sometimes to headache, sometimes to fatigue or lethargy. For the next few days, I could feel like I was walking through water, or even molasses. Sometimes nothing felt right and I didn't know how to explain it. Sometimes I felt nothing at all, as though I was a passive observer of my own tortured existence. All the while my mouth was very dry.
Hour three, I approached panic. Google, that most trustworthy of advisors, reminded me to seek immediate medical attention should my erection last longer than four hours. It started looking like an embarrassing cab ride to the ER, or maybe a humiliating 911 call.
A year after starting Trazodone I had a diminishing harvest of pros to weigh against the proliferating cons. Having tripled my starting dose I was less than optimistic as my insomnia returned and my mood dipped. My doctor decided it was time to drop the Trazodone and try something new. I went along.
Three hours and fifty-five minutes. The throbbing subsided, albeit slowly. The pain gradually lessened. I mopped the sweat off my face and changed into my third dry shirt of the day. Hours passed, the erection subsided. I felt a wash of relief and prayed it would never happen again. The very next week my prayers would prove pointless.
Meds, to be clear, are not a cure for depression, but can be an effective part of the treatment. I knew this going in and had decided to give medication a try on the long-standing advice of my therapist. Despite my doctor's assurances, though, my first experience with antidepressants left me weary. My doctor prescribed mirtazapine for the second go, but I, perhaps foolishly, opted for a different route. That's a story for another time.Â
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