Refractory Priapism Induced by Antipsychotics: A Case Report on Risperidone

Introduction
Priapism is a rare but serious medical condition that can have severe consequences, including permanent erectile dysfunction. While multiple causes exist, drug-induced priapism, particularly from antipsychotic medications, is a significant concern. A recent case study highlights the association between risperidone, an atypical antipsychotic, and refractory priapism, emphasizing the need for awareness and prompt medical intervention. Visit https://www.clinmedcasereportsjournal.org/acr for more groundbreaking research in this field.

Understanding Priapism and Its Implications

• Priapism is defined as a prolonged, painful erection that persists beyond sexual stimulation.
• It is classified into two main types:
  • Ischemic priapism (veno-occlusive): A medical emergency requiring immediate intervention.
  • Non-ischemic priapism (arterial): Less common and not as urgent but still requiring assessment.
• Drug-induced priapism, particularly from α1-adrenergic antagonist effects, is a known side effect of some psychotropic drugs, including risperidone.

Case Summary: Priapism Linked to Risperidone
A 23-year-old male with mild autism, receiving 6 mg of risperidone daily, presented with a persistent, painful erection lasting four days. Despite initial pharmacological interventions, the priapism was refractory, necessitating multiple surgical interventions, including:

• Winter’s surgical technique
• Ebbehoj’s procedure (distal cavernous-spongy shunt)
• Brant modification

After these interventions, the patient recovered without erectile dysfunction, and his psychiatric management was adjusted to quetiapine.

External Medical Insight: Recognizing the Risks
The American Urological Association (AUA) underscores the importance of timely intervention in ischemic priapism, as delays increase the risk of permanent damage. Studies have shown that priapism lasting beyond 24 hours significantly heightens the likelihood of erectile dysfunction.

Study Reference and Additional Resources
Read the full study at https://doi.org/10.29328/journal.acr.1001070.
For more articles on psychiatric medications and their effects, explore our related research section.

Preventative Considerations and Conclusion

• Clinicians prescribing antipsychotics should be aware of priapism as a potential side effect.
• Patients with risk factors such as blood dyscrasias, α-blocker use, or psychoactive substance consumption should be monitored closely.
• Early urological intervention is crucial to prevent irreversible complications.

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