Priapism is a urological emergency that results in a penile or clitoral engorgement, having several triggers by the use of medications, including psychiatric drugs, such as antipsychotics and antidepressants.
The most common priapism presentation is the ischemic type that can result in the fibrosis of corporus cavernosus, with a significant risk of persistent erectile dysfunction. It is believed that, in the case of antipsychotic use, priapism is mediated by an imbalance in alpha-1-adrenergic blocking, with large variation affinity for alpha-1-adrenergic receptors among antipsychotics. This case report contributes to the study of this rare but severe side effect. Priapism can limit both treatment adherence and the reproductive future of our patients. We describe a case report of a patient with a delusional hypochondriac syndrome who had multiple priapism episodes using clozapine 50 mg/daily. In conclusion, we make brief comments on priapism management, a hard clinical dilemma.
Oxford medical case reports. 2015 Mar 17*** epublish ***
Fabrício Donizete da Costa, Karina Toledo da Silva Antonialli, Paulo Dalgalarrondo
Department of Medical Psychology and Psychiatry, Medical School , University of Campinas (UNICAMP) , Campinas, São Paulo , Brazil. , Department of Medical Psychology and Psychiatry, Medical School , University of Campinas (UNICAMP) , Campinas, São Paulo , Brazil. , Department of Medical Psychology and Psychiatry, Medical School , University of Campinas (UNICAMP) , Campinas, São Paulo , Brazil.