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Priapism associated with the switch from oral to injectable risperidone.
Alla Kirshner1, Robert R Davis
1Department of Psychiatry, University of Manitoba, Canada. dimamexico@hotmail.com
Journal of Clinical Psychopharmacology
|November 18, 2006
Summary
Priapism, a rare side effect of psychotropic drugs, can occur with risperidone. This case highlights priapism in a patient switched to injectable risperidone, emphasizing prompt medical intervention.
Area of Science:
- Psychiatry
- Pharmacology
- Urology
Background:
- Priapism is a serious adverse effect linked to psychotropic medications, particularly atypical antipsychotics.
- Alpha-adrenergic antagonism is the presumed mechanism for drug-induced priapism.
- Risperidone, an atypical antipsychotic, exhibits significant alpha1-adrenergic blockade properties.
Observation:
- Seventeen cases of risperidone-associated priapism have been documented, primarily with oral formulations.
- No prior reports exist for priapism associated with injectable risperidone formulations.
- A 50-year-old male patient developed priapism during a transition from oral to intramuscular risperidone.
Findings:
- This case represents the first reported instance of priapism linked to injectable risperidone.
- The switch to the intramuscular preparation of risperidone precipitated the event.
- Early recognition and intervention are critical for managing priapism.
Implications:
- Clinicians should maintain a high index of suspicion for priapism when initiating or switching risperidone formulations.
- Awareness of this potential side effect is crucial for patient safety.
- Management strategies, including pharmacological interventions like benztropine, should be readily considered.
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