A Case Study to Explore Safe Psychotropic Medication(s) for a Patient Suffering From Priapism

Aims A 53-year-old male was admitted with non-resolving Priapism for 36 hours and reviewed advice regarding his psychotropic medications. He previously took Viagra about 2 days ago, had an erection which resolved spontaneously. underwent penile aspiration in the hospital provided relief. Following that, he developed signs of infection treated IV antibiotics. then waiting further surgical correction. Methods has a background history psychotic illness been Quetiapine, Mirtazapine, Sertraline Zopiclone, were kept on hold during admission. reported that currently suffers from depression psychosis, take form auditory hallucinations paranoid delusions. taking occasionally years, but not experienced side-effects like this before. is social drinker smoked cannabis. Results From above scenario, there appears to be two clinical questions: 1. Are current medications responsible priapism? 2. What medication(s) would suitable alternative if priapism indeed caused by drug regimen? The major causes are: direct trauma; haematological diseases; neurological cerebrovascular Medications; TPN Neoplasm. Apart medication side-effects, these other ruled out. Summary Product Characteristics mirtazapine, sertraline, quetiapine zopiclone studied their relative risk causing priapism, summarised below: • Mirtazapine: unknown Sertraline: rare Quetiapine: Zopiclone: listed However, paper Salonia et al found all except Zopiclone can increase priapism. Internationally published case reports also list priapism-associated as: risperidone; quetiapine; sildenafil; mirtazapine; citalopram; chlorpromazine olanzapine. Anti-psychotics cause Alpha-1 blockade anticholinergic actions. Most antipsychotics have action. demonstrates least alpha-1 Amisulpride acts blocking dopaminergic receptors brain. Conclusion Thus, it clear discussion possibility Priapism. patient advised low dose afterwards, no complications noted.