Kurt Aydın
Department of Psychiatry, Niğde Training and Research Hospital, Niğde, Turkey.
Psychiatry Clin Psychopharmacol. 2022 Dec 1;32(4):355-357. doi: 10.5152/pcp.2022.21299. eCollection 2022 Dec.
Priapism is a painful and prolonged erection of the penis without sexual stimulation. Priapism can be seen due to both typical and atypical antipsychotic drug use. A 51-year-old male who was followed up with a diagnosis of schizophrenia for 30 years and was switched from oral aripiprazole to paliperidone palmitate due to psychotic exacerbation was reported in this study. About 1 month after starting the drug, the patient presented to the emergency department with a painful and prolonged penile erection lasting 3-4 hours. Following the diagnosis of priapism by urology, the patient was relieved by intracavernous adrenaline injection and corpus cavernosum drainage and was referred to psychiatric consultation. Since the patient's examination, history, and laboratory tests could not detect a condition that could cause priapism, it was thought that priapism might be due to antipsychotic medication. One week after stopping paliperidone palmitate injection, the patient had another attack of priapism. Ten days after the second priapism, the patient was started on olanzapine, 10 mg/day, which was increased to 20 mg/day in the follow-up. The patient has been using olanzapine 20 mg/day for the past year. He is still psychiatrically stable and has no signs of priapism. To the best of our knowledge, this is the second case of recurrent priapism associated with paliperidone palmitate use.
阴茎异常勃起是指在没有性刺激的情况下阴茎出现疼痛且持续的勃起状态。使用典型和非典型抗精神病药物均可能引发阴茎异常勃起。本研究报告了一名51岁男性，他被诊断为精神分裂症并接受了30年的随访，因精神病性症状加重，从口服阿立哌唑换用棕榈酸帕利哌酮。在开始用药约1个月后，患者因阴茎疼痛且持续勃起3 - 4小时前往急诊科就诊。经泌尿外科诊断为阴茎异常勃起后，通过海绵体内注射肾上腺素和海绵体引流使患者症状缓解，并被转介至精神科会诊。由于对患者的检查、病史及实验室检查均未发现可导致阴茎异常勃起的病症，故认为阴茎异常勃起可能是由抗精神病药物引起的。在停用棕榈酸帕利哌酮注射剂一周后，患者再次出现阴茎异常勃起发作。在第二次阴茎异常勃起发作十天后，患者开始服用奥氮平，起始剂量为每日10毫克，随访中增至每日20毫克。在过去一年里，患者一直服用每日20毫克的奥氮平。他目前精神状态仍稳定，且没有阴茎异常勃起的迹象。据我们所知，这是第二例与使用棕榈酸帕利哌酮相关的复发性阴茎异常勃起病例。
