Priapism and quetiapine: a case report

Area of Science:

• Psychiatry
• Pharmacology
• Sexual Health

Background:

• Priapism is a medical emergency defined as a persistent erection lasting over six hours, often unrelated to sexual stimulation.
• Antipsychotic medications, including quetiapine, have been associated with priapism, although rarely.
• Recreational drug use, particularly stimulants like amphetamine, is prevalent in certain populations and can have various physiological effects.

Observation:

• A case report details a gay male patient attending an HIV/AIDS mental health clinic.
• The patient developed severe priapism while being treated with quetiapine.
• The patient also reported concurrent recreational amphetamine use.

Findings:

• The co-occurrence of quetiapine and amphetamine use was associated with the development of serious priapism in this patient.
• This suggests a potential pharmacodynamic or pharmacokinetic interaction between quetiapine and amphetamine contributing to priapism.
• The patient's demographic (gay male) and high-risk behavior (amphetamine use) are important contextual factors.

Implications:

• Healthcare providers should be aware of the potential risk of priapism when prescribing quetiapine to patients using recreational amphetamines.
• This association warrants further investigation to understand the underlying mechanisms and establish causality.
• Clinical decision-making for pharmacotherapy in patients with a history of or risk for substance use should carefully weigh potential adverse effects like priapism.