Chaitanya Patel*, Quratulain Anaya Javed, Suprada S Vinyak, Anurag Prathipati, Stephanie Ogbonda and Praveen Kumar Vodala


Priapism is a rare side effect of anti-psychotics. Both typical and atypical anti-psychotics can cause priapism.
Priapism means persistent and most of the times painful penile erection not associated with sexual stimulation.
Priapism can cause urinary retention, cavernosa fibrosis, gangrene and even impotency if it is not treated properly
in time. About 50% of priapism patients end up having impotency.[1] Drugs account for 25-40% of priapism.[2] The
most common drugs causing priapism are anti-hypertensives and anti-psychotics.[1] In anti-psychotics, second
generation anti-psychotics are more associated with priapism. But the information in the literature is limited. Most
common anti-psychotics causing priapism are Risperidone, Olanzapine and Quetiapine. We are reporting a case of
recurrent episode of priapism due to Quetiapine use followed by Olanzapine. As per the study in 2010,[2] the
number of reported cases of priapism were 23, 14 and 6 for Risperidone, Olanzapine and Quetiapine respectively.
The dispute in the Olanzapine and the Quetiapine reported cases and the scientifically proven affinity of the two
drugs for alpha-1 receptors may be due to the issues of length and the use of the drugs in the market or due to lack
of reporting of the cases of priapism of Quetiapine. Dose and the duration of treatment is not related with the
occurrence of priapism.[1] But as per this case report, we can assume that the sudden rise of drug level in the body
causes priapism because priapism was seen in this patient only when Quetiapine was first introduced to the patient
and then introduced to the patient after a period of one year. But when the patient was on Quetiapine on a
maintenance dose for a long time, it did not cause priapism.

Keywords: .

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