SEPT, Weller Wing, Ampthill Road, Bedford, Bedfordshire, UK.
Ther Adv Psychopharmacol. 2013 Oct;3(5):298-300. doi: 10.1177/2045125313488132.
Clozapine (Denzapine) is a treatment for resistant schizophrenia. Among the serious but rare side effects of clozapine are agranulocytosis and priapism. We hereby present the case of a 30-year-old man with a diagnosis of schizophrenia who has spent nearly 12 years of his adult life on various psychiatric in-patient units including open wards, secure units, psychiatric intensive care units and rehab wards. Diagnosed at the age of 15, he only responded to clozapine at the age of 18. Whilst being on clozapine he developed priapism in June 2010 and needed emergency surgical treatment in the form of surgical decompression. He again responded only to clozapine and fortunately he did not redevelop priapism; however, he was readmitted in February 2011 due to relapse, and he remained resistant to other antipsychotics. He was rechallenged with clozapine and recovered, but unfortunately redeveloped priapism which required emergency surgical and medical intervention (goserline acetate and tinzaperin injection). In order to relieve the recurrent priapism, he agreed to continue clozapine and goserline acetate injection. This decision was made by the patient in a compos mentis state. As far as we are aware, this is the first time goserline acetate has been reported as a successful treatment for clozapine-induced priapism.
氯氮平（Denzapine）是一种治疗耐药性精神分裂症的药物。氯氮平的严重但罕见的副作用包括粒细胞缺乏症和阴茎异常勃起。我们在此介绍一位 30 岁男性的病例，他被诊断患有精神分裂症，成年后近 12 年一直在各种精神科住院病房，包括开放病房、安全病房、精神科重症监护病房和康复病房。他在 15 岁时被诊断出患有精神分裂症，直到 18 岁才开始对氯氮平有反应。在服用氯氮平期间，他于 2010 年 6 月出现阴茎异常勃起，并需要紧急手术治疗，形式为手术减压。他再次仅对氯氮平有反应，幸运的是他没有再次出现阴茎异常勃起；然而，他于 2011 年 2 月因复发而再次入院，并且对其他抗精神病药物仍然有抵抗。他再次接受氯氮平治疗后康复，但不幸再次出现阴茎异常勃起，需要紧急手术和药物干预（醋酸戈舍瑞林和丁卡因注射）。为了缓解反复发生的阴茎异常勃起，他同意继续使用氯氮平和醋酸戈舍瑞林注射。这一决定是在患者神志清醒的情况下做出的。据我们所知，这是首次报道醋酸戈舍瑞林是治疗氯氮平引起的阴茎异常勃起的有效方法。
