Intracavernous injection of sympathomimetics (e.g. phenylephrine, epinephrine, norepinephrine, metaraminol). Systemic treatment of underlying disease (e.g. sickle cell disease) plus intracavernous treatment for patients with underlying

disorders or haematologic pathology. Surgical shunts, including distal shunts (e.g. Winter, Ebbehoj and Al-Ghorab procedures); the cavernospongious shunt (i.e. Quackels procedure); and cavernosaphenous shunt (i.e. Grayhack procedure). Conclusion Antipsychotics, #Selleckchem Verteporfin keyword# in particular α-adrenergic receptor antagonists like risperidone, may cause priapism. Although a rare side effect, it may have devastating consequences if not treated promptly. This highlights the need for increased awareness Inhibitors,research,lifescience,medical to facilitate early recognition and treatment. Special care must be taken when prescribing risperidone in patients potentially more susceptible to this side effect, such as those with comorbid pathology (i.e. sickle cell disease) or when treatment might also increase their risk [Brichart et al. 2008; Lapan et al. 1980]. Patients should be educated on distinguishing priapism from a normal erection and the need to report priapism promptly if it occurs should be emphasized, especially in at-risk patients. We could not find any studies that looked at alternative antipsychotic prescribing

for patients who are at high risk of priapism, Inhibitors,research,lifescience,medical however given that drugs with high α-adrenergic antagonistic properties seem to increase the risk, antipsychotics with lower α-adrenergic affinity would be the preferred choice of treatment. It is unclear from the evidence whether priapism is idiosyncratic Inhibitors,research,lifescience,medical or a dose-related event.

The literature review does suggest that some patients seemed to develop priapism only after an increase in medication dose (Table 1). Overall our review shows that the aetiopathogenesis is far from being fully understood. We anticipate, with future advances in research, Inhibitors,research,lifescience,medical that physicians will be better able to identify patients who are at higher risk. Acknowledgments We would like to thank Olubanke Olofinjana, our team pharmacist at the South London and Maudsley NHS Foundation trust for her invaluable guidance and advice. Footnotes Funding: This research received no specific grant crotamiton from any funding agency in the public, commercial, or not-for-profit sectors. Conflict of interest statement: The authors declare no conflicts of interest in preparing this article. Contributor Information Lise Paklet, St Charles Hospital, London. Anne Mary Abe, Neuroscience Department, Institute of Psychiatry, Kings College London, De Crespigny Park, London SE5 8AF, UK. Dele Olajide, South London and Maudsley NHS Foundation Trust, London, UK.
Current pharmacotherapeutic strategies to treat symptoms of schizophrenia are generally focused on blockade of the dopamine and serotonin receptors [Freedman, 2003; Muscatello et al. 2010; Catafau et al. 2011].