How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Phil, MD Your Own Question
Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57257
Experience:  GP in the United States
Type Your Medical Question Here...
Dr. Phil, MD is online now

which sleep medication is least likely to cause impotence? I

Resolved Question:

which sleep medication is least likely to cause impotence?

I have been on amitryptiline for years. Since doing a sleep restriction regime for the past year and two months (NB, suspended for three months due to a football ijury that stopped me doing exercise), I have cut my dose from 100 mg to 20 mg.

I know of ED drugs. But if I am unable to completely get off sleeping pill. What could I switch to that would have least impotence effect. Do all sedatives come with ED side effects?

I asked this question once before on this site, and was advised on a certain pill as it had no ED side effect. However, I then did a bit of research which said erectile dysfunction was among its side effects.

Can you help?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Chip replied 3 years ago.
Hi--can you first tell me what your erection problem is and what you mean by impotence? Is amitryptilene the only thing you've had for sleeping problems?
Expert:  Dr. Phil, MD replied 3 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

I would ask your doctor about trazodone

This is a medication that is commonly used for sleep and actually HELPS erections.

It might be a good option for you
Customer: replied 3 years ago.

Hello Dr Phil

Thanks for the answer

However, I'm yet more confused.

I contacted this service two months ago and was given contrary information.

A Dr. Kaushik said:

A good alternative for amitriptyline is trazodone which is an anti depressant itself but has a more profound and better known sedative action owing to which it is often used for insomnia. It is to be taken at dose of 25 mg at bedtime to start with and then you may titrate it up to 50 mg at bedtime. However on a flip side it also may lead to erection problem but not as severely and frequently as amitriptyline.


He says trazodone causes erectile problems, and you are saying the contrary. Why is this?

Expert:  Dr. Phil, MD replied 3 years ago.
I guess it depends on your definition of "problem"

Trazodone is well known to cause erections.

in rare cases, at high doses, it can cause a dangerous erection called priapism

This rarely if ever happens at 50 mg doses and will help you erections a lot

That may be a problem in some but in you I would consider it a therapy!
Customer: replied 3 years ago.

That does sound the ticket. If so, it could have stopped a lot of heartache in my life. I've dropped my amitryptiline to 20 mg, and am loathe to take a higher sedative dose.


what would you recommend trazodone dosage to be in the same region as 20 mg of amitryptiline?

Thank you again

Expert:  Dr. Phil, MD replied 3 years ago.
Start at 25. Go up to 50 if needed
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57257
Experience: GP in the United States
Dr. Phil, MD and 2 other Medical Specialists are ready to help you