Ziprasidone-induced priapism requiring surgical treatment

Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
European Psychiatry (Impact Factor: 3.44). 02/2006; 21(1):48-50. DOI: 10.1016/j.eurpsy.2005.07.007
Source: PubMed


Both typical and atypical antipsychotic psychotropics have been reported to cause ischemic priapism presumptively secondary to alpha1-adrenergic blockade. This condition is a urologic emergency for if not evaluated and treated appropriately, long-term sequelae include erectile dysfunction and impotence. This paper addresses the first reported case of priapism requiring surgical intervention presumed to be secondary to ziprasidone. Increased clinician and patient education regarding priapism is required in order to minimize this adverse event and to maximize immediate treatment.

5 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Metodologia della Ricerca. 1.0: Disfunzioni sessuali indotte da antidepressivi. 1.1: Epidemiologia. Problemi di metodologia della ricerca. 1.2 Meccanismi d'azione degli antidepressivi sulla funzionalità sessuale 1.3 Antidepressivi e disfunzioni sessuali. 1.4 Trattamento delle disfunzioni sessuali indotte da antidepressivi. 1.5 Disfunzioni sessuali indotte da antidepressivi: conclusioni. 2.0 Disfunzioni sessuali indotte da antipsicotici. 2.1 Epidemiologia 2.2 Meccanismi d'azione dei neurolettici sulla funzionalità sessuale. 2.3 Neurolettici e disfunzioni sessuali. 2.4 Trattamento delle disfunzioni sessuali indotte da antipsicotici. 2.5 Disfunzioni sessuali indotte da neurolettici: conclusioni. 3.0 Disfunzioni sessuali indotte da stabilizzatori dell'umore e da benzodiazepine 3.1 Stabilizzatori dell'umore e disfunzioni sessuali. 3.2 Benzodiazepine e disfunzioni sessuali. Abstract Sexual Dysfunction is a potential side effect of psychotropic drugs: this article is a critical review of the literature. Many studies have been published, but only some used a validated sexual function rating scale and most lacked either a baseline or a placebo control or both. Moreover, investigations of sexual dysfunction associated with psychotropic drugs have further methodological flaws. Certainly, there is consistent evidence to suggest that a large number of psychiatric medications adversely affect one or more of the three phases of sexual response (desire, arousal and orgasm). Among the antidepressants, those with strong serotoninergic properties have the highest rate of sexual side effects. Among the antipsychotics, "prolactin-raising" are probably associated with more sexual dysfunction, even if further studies are needed to determine more thorough evidence: the reviewed papers show no clear consistency regarding potential advantages of one drug over another and information on this topic is largely based on studies providing a low level of evidence. There is insufficient evidence to make conclusions about mood stabilizers and the anxiolytics.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary form only given. There is an increasing interest in combining large numbers of relatively low-power lasers to produce much more powerful, high-brightness laser beams. Coherent combining and wavelength (spectral) combining are the two main approaches being studied. We have been concentrating on wavelength beam combining with fiber lasers and have previously demonstrated this concept at low power. Here we discuss recent work to extend this idea to a master-oscillator power-amplifier (MOPA) configuration by adding a power amplification stage to each oscillator fiber and demonstrating recombination at higher powers.
    Lasers and Electro-Optics, 2002. CLEO '02. Technical Digest. Summaries of Papers Presented at the; 02/2002
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Ziprasidone is a newer "atypical" or "second-generation" antipsychotic. Oral ziprasidone (ziprasidone hydrochloride) is approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia, and acute manic or mixed episodes associated with bipolar disorder (with or without psychotic features). Ziprasidone intramuscular (ziprasidone mesylate) is FDA-approved for acute agitation in patients with schizophrenia. Oral ziprasidone appears efficacious, and has been shown to have some limited clinical advantages over chlorpromazine and haloperidol in ameliorating negative symptoms of schizophrenia. In Phase 2 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for schizophrenia, ziprasidone did not match the clinical performance of olanzapine and risperidone, appearing closer in overall effectiveness to quetiapine. The rate of dose titration and the dose achieved may have an important bearing on ziprasidone's efficacy profile. In studies of usage for acute agitation in individuals with schizophrenia, intramuscular ziprasidone has been shown to be efficacious and relatively well tolerated. Regarding tolerability, ziprasidone, has important advantages in that it is not associated with clinically significant weight gain or adverse changes in cholesterol, triglycerides, or glycemic control, and patients may experience moderate improvement in these measures when switching to ziprasidone from a different antipsychotic agent. It also lacks significant persistent effects on prolactin levels, is not anticholinergic, and only infrequently causes extrapyramidal side effects or postural hypotension, although it can be associated with somnolence. This tolerability profile may be quite valuable in the treatment of some patients. Ziprasidone may prolong the electrocardiogram (ECG) QTc interval (QT interval corrected for heart rate by a standard algorithm), but after 5 years' clinical availability ziprasidone (by itself) does not appear to pose a substantial clinical problem in this regard. Therefore, ziprasidone may be considered a first-line drug option in the treatment of schizophrenia or manic episodes, but, in view of the differences among antipsychotic medications, drug selection should be guided by the patient's individual characteristics and situation.
    CNS Drug Reviews 02/2007; 13(2):137-77. DOI:10.1111/j.1527-3458.2007.00008.x · 4.92 Impact Factor
Show more