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Stuttering priapism associated with topiramate
Narayana Manjunatha1, Vivek Benegal2
1Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, India.
General Hospital Psychiatry
|June 29, 2015
Summary
Priapism, a prolonged erection, can be a medical emergency. This case report details reversible priapism linked to topiramate, an anticraving medication, highlighting a potential drug side effect.
Area of Science:
- Neuroscience
- Pharmacology
- Urology
Background:
- Priapism is a prolonged penile erection unrelated to sexual stimulation, often a medical emergency.
- Several medications, including antianxiety, antidepressant, and antipsychotic drugs, have been linked to priapism.
- Topiramate is an anticonvulsant and migraine prophylactic also used off-label for substance use disorders.
Observation:
- A case report details a patient with alcohol dependence treated with topiramate for craving reduction.
- The patient developed episodic priapism shortly after initiating topiramate therapy.
- A reduction in topiramate dosage led to decreased priapism severity, and discontinuation resolved the condition.
Findings:
- Topiramate use was associated with reversible stuttering priapism in this patient.
- This represents the first documented case of priapism linked to topiramate in medical literature.
Implications:
- Clinicians should consider topiramate as a potential cause of priapism, particularly in patients with alcohol dependence.
- This finding expands the known side effect profile of topiramate.
- Further research may be warranted to investigate the mechanism and prevalence of topiramate-induced priapism.
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