Ziprasidone
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Ischaemic priapism: case report A 50-year-old man developed ischaemic priapism while receiving ziprasidone. The man, who had bipolar I disorder, had been receiving ziprasidone [initial dosage not stated] and valproate semisodium for the previous 6 years. His dose of ziprasidone was 60mg in the morning and 80mg at night, which had been his regimen for several years [frequency not clearly stated]. His psychiatrist advised him to co-ingest ziprasidone with food to improve the bioavailability. The following day, after ingestion of ziprasidone 80mg at bedtime and 60mg in the morning with food, he presented with a persistent painful penile erection lasting 10 hours. The man underwent corpora cavernosal drainage and irrigation with phenylephrine. He then underwent a proximal Winter shunt with corpora cavernosal drain instillation and phenylephrine administration; however, this was unsuccessful. Spontaneous flaccidity was achieved after 3 days. Ziprasidone was concluded as the likely aetiology of the ischaemic priapism. He had a history of erectile dysfunction treated with sildenafil, and he had taken his last dose 72 hours before priapism onset. Author comment: "This patient had a prolonged history of fasted-state ziprasidone administration, which upon correction elicited a rapid dose-dependent α-mediated ischemic-priapismic reaction to amplified drug concentrations, mandating emergent surgical interventions." Denton K, et al. Ziprasidone-induced ischemic priapism requiring surgical intervention: a case report. Primary Care Companion to the Journal of Clinical Psychiatry 15: No. 1, 2013. Available from: URL: http://dx.doi.org/10.4088/ 803096596 PCC.12l01443 - USA
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Reactions 7 Dec 2013 No. 1481
