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Priapism, loss of appetite and irritability: 2 case reports In a case series, a 7-year-old boy and an 11-year-old boy were described, who developed priapism, loss of appetite or irritability during treatment with atomoxetine or methylphenidate for attention-deficit hyperactivity disorder (ADHD) [not all routes and outcomes stated]. Case 1: An 11-year-old boy, who had a normal developmental history, was diagnosed with combined type ADHD two years previously. Since the diagnosis of ADHD, he had been followed in a psychiatry clinic. One year before the presentation, he started receiving osmotic release oral system (OROS) methylphenidate [Concerta] 36 mg/day with no remarkable side effects. His parents decided to stop methylphenidate treatment without consulting his psychiatrist to observe his function without medication. Following two months (during a medication-free period), his peer relationships and academic performance worsened. Hence, his family re-started treatment with methylphenidate at a dose of 36 mg/day in the morning. Two hours after the administration of first methylphenidate dose, he developed a painful erection (priapism), which continued throughout the day. Therefore, he was transferred to the emergency department. He was consulted to urology, and underwent a needle aspiration. After the procedure, his painful priapism was resolved. His medical work-up was normal. He had no significant medical history. After one week, he was evaluated at the child psychiatry clinic. Subsequently, his treatment with methylphenidate was changed to atomoxetine. His ADHD symptoms exhibited significant improvement without any remarkable side-effects. Case 2: A 7-year-old boy, who had a normal developmental history, presented to an outpatient clinic with symptoms of ADHD, including impulsivity, hyperactivity and inattentiveness for the past few years. After starting school, his symptoms worsened. Based on the psychiatric assessment, a diagnosis of ADHD was made. Subsequently, he was treated with long-acting methylphenidate [Medikinet retard] 10 mg/day. Ten days after the treatment initiation, methylphenidate was discontinued because of irritability and loss of appetite. Therefore, he started receiving atomoxetine 10 mg/day in the evening, which was increased to 25 mg/day after two weeks. On the next morning (after a dose increase to 25 mg/day), he experienced a painful erection (priapism) in the absence of sexual stimulation. His painful erection lasted for whole day, which resolved spontaneously after 12h under emergency observation. His parents stopped treatment with atomoxetine and consulted the psychiatry clinic. He denied the use of herbal products, substances or any other drugs. His medical history was unremarkable, except for allergic asthma. His laboratory examinations were normal. Subsequently, he was started on osmotic release oral system (OROS) methylphenidate [Concerta] 18 mg/day. Following six months, his ADHD symptoms improved with a tolerable level of loss of appetite. No painful erection was observed. Ka