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Priapism is a prolonged erection lasting 4 hours or more. Without treatment, it can cause permanent erectile dysfunction (impotence). The FDA has recently issued a warning about the risk of priapism from ADHD drugs, which is particularly serious in young men who are less likely to report the condition or seek treatment.

What is Priapism?

Priapism is a prolonged, unwanted erection of the penis that is not caused by sexual stimulation or arousal. It occurs when blood in the penis becomes trapped, leading to an abnormally long-lasting erection (at least 4 hours). The condition is uncommon and requires emergency medical treatment.

What is the problem?

Without treatment, priapism can cause permanent tissue damage that may result in permanent inability to get or maintain an erection (erectile dysfunction). Priapism is a side effect of some drugs used to treat ADHD, one of the most common childhood brain disorders. Younger males, especially those who have not yet reached puberty, may not recognize the symptoms of priapism, or they may be too embarrassed to tell an adult.

FDA Safety Warning for Priapism

December 17, 2013 — The U.S. Food and Drug Administration (FDA) has issued a Drug Safety Communication about the risk of priapism in men who are taking drugs in the methylphenidate class for the treatment of ADHD. The FDA has received 15 reports of priapism associated with ADHD drugs between 1997 and 2012. Of the 14 cases reporting an age, 12 occurred in children (median age 12.5 years old). Some patients were hospitalized, including two who required surgery. Click here to read more.

ADHD Drugs Linked to Priapism

Other Drugs Linked to Priapism

According to UCSF Health, the following drugs have been associated with priapism:

  • Erectile dysfunction drugs
  • Antidepressants
    • Bupropion
    • Trazodone
    • Fluoxetine
    • Sertraline and lithium
    • Desyrel
  • Antipsychotics
    • Clozapine
  • Antianxiety Agents
    • Hydroxyzine
  • Psychotropics
    • Chlorpromazine
  • Alpha-adrenergic Blocker
    • Prazosin
  • Hormones
    • Gonadotropin-releasing hormone (in hypogonadal men)
    • Testosterone
  • Anticoagulants
    • Heparin
    • Coumadin

Priapism Treatment

Treatment for priapism may begin with application of ice to the penis to reduce swelling. If an artery has ruptured, surgery may be necessary to tie off the artery and restore normal blood-flow to the penis. Doctors may also use injection drugs to narrow arteries in the penis or implant a shunt to divert blood-flow. Another technique, aspiration, involves draining blood from the penis to reduce pressure and swelling.