Priapism

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Departments of Internal Medicine & Psychiatry, Yale University School of Medicine, New Haven, CT, USA

Priapism is a prolonged, persistent, and often painful penile erection, not usually initiated by sexual activity. A common cause among adults is intracavernous drug therapy for erectile dysfunction. Medical conditions that can cause it include hematologic disorders (e.g., sickle cell disease , leukemias ), perineal trauma, and medications (e.g., anticoagulants, some antihypertensives). Patients with priapism generally have significant pain.

Psychotropic Medications and Priapism

Psychotropic medications are rarely associated with priapism. The mechanism is thought to be alpha adrenergic blockage of receptors in the corpora cavernosa of the penis. Trazodone and phenothiazine antipsychotics are implicated in a majority of cases [1]. Many case reports exist for low-potency typical antipsychotics. Fewer case reports are recorded for high-potency typical antipsychotics and atypical antipsychotics. Prazosin , often used in psychiatric practice, can also cause priapism.

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