Priapism Followed by Discontinuation of Methadone: A rare Case Report
Abstract
Objective: Priapism is defined by persistent, painful penile erection which occurs without sexual stimulation. Methadone is used as an analgesic and is also used in detoxification and maintenance protocol for opioid dependence treatment. Here we will report a case of a male with priapism after rapid discontinuation doses of methadone.
Case presentation: The case was a young married male who referred to a psychiatry clinic due to long-time spontaneous erections. The patient had no history of mental disorders, trauma or sickle cell anemia. He used to smoke opium for five years and used methadone for four years at a dose of 17 cc daily, which he abruptly discontinued. Then he often experienced spontaneous and painful erections without physical or mental stimulation that caused him shame and embarrassment .
Conclusion: In this case, chronology indicates that rapid discontinuation of methadone was possibly responsible for the occurrence of priapism. This may have happened due to a compensatory reaction to methadone side effect of erectile dysfunction, followed by its rapid withdrawal.
Van der Horst C, Stuebinger H, Seif C, Melchior D, Martinez-Portillo FJ, Juenemann KP. Priapism - etiology, pathophysiology and management. International braz j urol : official journal of the Brazilian Society of Urology 2003; 29: 391-400.
Salonia A, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Vardi Y, et al. European Association of Urology guidelines on priapism. European urology 2014; 65: 480-489.
Furtado PS, Costa MP, Ribeiro do Prado Valladares F, Oliveira da Silva L, Lordelo M, Lyra I, et al. The prevalence of priapism in children and adolescents with sickle cell disease in Brazil. International journal of hematology 2012; 95: 648-651.
Kaufman KR, Stern L, Mohebati A, Olsavsky A, Hwang J. Ziprasidone-induced priapism requiring surgical treatment. European psychiatry : the journal of the Association of European Psychiatrists 2006; 21: 48-50.
Kulmala RV, Lehtonen TA, Tammela TL. Priapism, its incidence and seasonal distribution in Finland. Scandinavian journal of urology and nephrology 1995; 29: 93-96.
Fredheim OM, Moksnes K, Borchgrevink PC, Kaasa S, Dale O. Clinical pharmacology of methadone for pain. Acta anaesthesiologica Scandinavica 2008; 52: 879-889.
Senay EC, Dorus W, Goldberg F, Thornton W. Withdrawal from methadone maintenance. Rate of withdrawal and expectation. Archives of general psychiatry 1977; 34: 361-367.
Eiland LS, Bell EA, Erramouspe J. Priapism Associated With the Use of Stimulant Medications and Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Children. The Annals of pharmacotherapy; 2014.
Asad Pour M, Mirzaei V, Bidaki R, Ghorbani AA, The Frequency of Premature Ejaculation in Patients with Irritable Bowel Syndrome,Govaresh 2014, 19 (3), 202-207
Wang C, Pasulka P, Perry B, Pizzi WJ, Schnoll SH. Effect of perinatal exposure to methadone on brain opioid and alpha 2-adrenergic receptors. Neurobehavioral toxicology and teratology 1986; 8: 399-402.
Mohammadi RS, Mahdian M, Bidaki R, Essential Thrombocytosis Following Multiple Psychic Traumas, Emergency, 2014, 2 (4), pp. 178-179
Mostafavi SH, Fazilati M, Vahhabi MR, Omidvarinia Sh. Hepatotoxicity of Dorema aucheri (Bilhar) in albino mice. Arch Iran Med. 2013 Sep;16(9):530-2. doi: 013169/AIM.0010
Tatari F, Farnia V, Nasiri RF, Najafi F. Trazodone in methandone induced erectile dysfunction. Iranian journal of psychiatry 2010; 5: 164-166.
| Files | ||
| Issue | Vol 10 No 2 (2015) | |
| Section | Case Report(s) | |
| Keywords | ||
| Priapism Methadone Withdrawal Side effect Fluoxetine Pentoxifylline Case Report | ||
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