Olanzapine-Associated Priapism

M, Gordon; Groot, de Jan

doi:10.1097/00004714-199904000-00022

Cited by 16 publications

(6 citation statements)

References 3 publications

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“…[15][16][17] One patient experienced unwanted, prolonged erections lasting 15-30 minutes. 18 Four patients were treated for olanzapine-associated priapism, 13,[19][20][21] and one patient had reversible episodes of priapism lasting up to 2 hours. 22 Quetiapine and ziprasidone, however, have not been reported to cause priapism.…”

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confidence: 99%

Priapism Associated with Two Atypical Antipsychotic Agents

Reeves¹,

Mack²

2002

Pharmacotherapy

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Priapism has been associated with many antipsychotic agents, including clozapine, risperidone, and olanzapine. This prolonged, usually painful, penile erection rarely results from the alpha-adrenergic blocking action of antipsychotics. A 22-year-old African-American man developed priapism during treatment with risperidone and, on a later occasion, during treatment with ziprasidone. The problem resolved only with substitution of other drugs for these antipsychotics. Certain patients may be more vulnerable than others to this adverse effect. Clinicians must be aware of such complications and use caution when prescribing these drugs.

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confidence: 99%

Priapism Associated with Two Atypical Antipsychotic Agents

Reeves¹,

Mack²

2002

Pharmacotherapy

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“…Olanzapine has both a1 and a2-blocking characteristics and has been associated with several, 12 cases (Deirmenjian et al, 1998;Heckers et al, 1998;Gordon and de Groot, 1999 Matthews and Dimsadle, 2001;Seger and Lamberti, 2001;Songer and Barclay, 2001;Reeves and Mack, 2002;Childers et al, 2003;Bucur and Mahmood, 2004;Jagadheesan et al, 2004) of priapism (Table 2). Olanzapine has been implicated in priapism in three AfricanAmerican males.…”

Section: Resultsmentioning

confidence: 99%

“…The drugs used are phenylephrine, epinephrine and ephedrine. These measures should be started within 4-6 h to avoid the complications (Gordon and de Groot, 1999). Despite interventions there is a 50% chance of developing permanent damage (Compton et al, 2000).…”

Section: Resultsmentioning

confidence: 99%

Priapism associated with atypical antipsychotic medications: a review

Sood

James

Bailon

2008

International Clinical Psychopharmacology

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Priapism defined as persistent, painful and prolonged penile erection, was previously thought to be associated only with the use of the older, conventional first generation or typical antipsychotic medications as well as some other medications, notably, trazodone. The mechanism of priapism associated with antipsychotics is not clear but is thought to be related to alpha-adrenergic blockage that is mediated by the alpha receptors in the corpora cavernosa of the penis. Atypical antipsychotics, also known as second-generation antipsychotics, owing to their favorable side effect profile, are being prescribed with increasing frequency and are not as frequently considered to cause priapism. Some case reports reporting this side effect with their use, however, are found. Pubmed and Ovid databases were searched to obtain all articles and case reports of antipsychotic drug-induced priapism. Key search words included 'priapism', 'antipsychotics' and 'drug-induced priapism'. References of all identified studies were also reviewed. A total of 50 publications were obtained. Most of the atypical antipsychotics have been reported to cause priapism. These cases have occurred in patients shortly after having been started on the antipsychotic medications as well as in those who have been on them for an extended period of time without modification in dosage, and have also occurred sometimes, with the addition of another antipsychotic, lithium or serotonin-specific reuptake inhibitor. Priapism has been documented with nearly all the atypical antipsychotic medications. It is, however, a rarely reported side effect and therefore, underappreciated. Priapism can cause irreversible erectile dysfunction and is a urologic emergency. Clinicians should monitor patients on these medications for this rare, yet significant side effect. Furthermore, caution must be used when adding new drugs to the regimen and patients should be closely monitored for this side effect. Educating patients about the risk of developing priapism would help increase awareness of the side effect and promote early reporting thereby, decreasing long-term morbidity.

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“…The reason for drug-induced priapism is still completely unknown, but alpha-1 adrenergic receptor blockade in the corpus cavernosum of the penis is suspected (3). In the literature, olanzapine-induced priapism was reported as occurring olanzapine with low and high dosage, single and multiple medications, as well as short-term and long-term uses (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Contrary to others, priapism was observed with single-dose olanzapine in our case; furthermore, priapism occurred with repeated low doses of olanzapine.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Priapism Related with Low Single Dose Olanzapine

Yücel¹,

Yücel²,

Ozcan³

et al. 2016

West Indian Med J

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Priapism is defined as persistent prolonged erection of the penis, usually painful, without sexual arousal or desire, generally continuing for hours. Many medical situations and drugs, especially psychotropic agents, may cause priapism. The mechanism of psychotropic druginduced priapism is not fully known, but α1-adrenergic receptor blockade in the corpus cavernous is being accused. Priapism is an urgent situation for the health of the patient. Cavernous old blood is drained by a butterfly needle or a diluted solution of an alphaadrenergic agonist is injected into the corporal space. In the event failure of medical treatment, surgical interference may be needed to avert fibrosis and impotence due to tissue death. For preventing that condition, a fistula between the deep dorsal vein or saphenous vein and the glans penis, the corpus cavernosum, and corpus spongiosum is constituted to open a new way for the venous circulation.

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Olanzapine-Associated Priapism

Cited by 16 publications

References 3 publications

Priapism Associated with Two Atypical Antipsychotic Agents

Priapism Associated with Two Atypical Antipsychotic Agents

Priapism associated with atypical antipsychotic medications: a review

Recurrent Priapism Related with Low Single Dose Olanzapine

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