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Psychotropic medication and priapism: a comprehensive review
J W Thompson1, M R Ware, R K Blashfield
1Department of Psychiatry, University of Florida, Gainesville.
The Journal of Clinical Psychiatry
|October 1, 1990
Summary
Psychotropic medications, particularly those with alpha-adrenergic blocking properties like trazodone, are linked to priapism. Clinicians should warn patients and screen for prior prolonged erections to mitigate risks.
Area of Science:
- Pharmacology
- Urology
- Psychiatry
Background:
- Priapism is a recognized, severe adverse effect associated with psychotropic medication use.
- Clinicians are increasingly aware of the significant morbidity linked to drug-induced priapism.
Purpose of the Study:
- To review the literature associating psychotropic medications with priapism.
- To inform clinicians about specific drug classes and risk factors for priapism.
Main Methods:
- Literature review of reported cases and associations between psychotropic drugs and priapism.
- Analysis of medication properties, specifically alpha-adrenergic blockade.
Main Results:
- Medications with alpha-adrenergic blocking properties are most frequently implicated in priapism.
- Trazodone, certain antipsychotics, and prazosin are highlighted as common culprits.
- A history of prolonged erections or delayed detumescence is present in about 50% of priapism cases.
Conclusions:
- Awareness of the association between specific psychotropic agents and priapism is crucial for risk minimization.
- Forewarning patients about the risk of priapism and screening for prior prolonged erections are essential clinical practices.