Psychotropics in Medication-Induced Priapism: A Case Series and Narrative Literature Review.
Tam Dong, Archana Jhawar, Zane Elfessi
✦ AI-curated · Sources linked
Case in brief
This article is a narrative review with five additional cases, rather than a single-patient report. The authors searched PubMed for psychotropic-associated priapism and identified 117 cases; 85 had a clear association with medication use. Their five cases involved medications less commonly implicated in pharmacologically induced priapism. The review describes alpha-adrenergic antagonism as a likely mechanism, impairing the sympathetic response needed for penile detumescence. Ischemic priapism requires urgent assessment and may be managed with supportive measures, corporal irrigation and intracavernosal phenylephrine, or surgery; the implicated medication should be stopped or at least dose-reduced.
What made this case unusual
The five additional cases involved psychotropic medications less commonly associated with priapism, broadening the range of drugs clinicians may need to consider.
Diagnostic / clinical pearl
When assessing ischemic priapism, review psychotropic medications, including antidepressants and less commonly implicated agents, as potential contributors; the suspected medication may need to be discontinued or dose-reduced.
Why it matters
Prompt recognition matters because ischemic priapism can cause tissue injury, fibrosis, and permanent erectile dysfunction.