Priapism After a Suicide Attempt by Ingestion of Olanzapine and Gabapentin

Abstract

Key Words: Suicide • Olanzapine TO THE EDITOR: Priapism from any cause is an uncommon event. Of the 15%–41% of cases in which medications have been implicated, phenothiazine, antipsychotics, and heterocyclic antidepressants are among the most commonly associated.1 Because of their favorable side effect profile, atypical neuroleptics are being used more frequently; however, there have been several disturbing cases of priapism developing in association with the use of atypical neuroleptics. We describe here a case of priapism that occurred after ingestion of olanzapine and gabapentin. Case ReportMr. T., a 51-year-old man with schizoaffective disorder, had been treated with multiple medication combinations. He had experienced prolonged and painful erection once before, which occurred while taking trazodone. Fortunately, trazodone was immediately discontinued, and normal erectile function returned without further medical attention. For 3 months prior to admission, Mr. T. had been stable on olanzapine (5 mg/night), gabapentin (900 mg/day), and paroxetine (20 mg/night). After an argument with his girlfriend, Mr. T. took 100 mg of olanzapine and 1,500 mg of gabapentin in a suicide attempt and was admitted to the intensive care unit. Approximately 16 hours after ingestion, Mr. T. developed a painful erection after the insertion of a urethral