The FDA has recently warned about the risk of priapism (unwanted erection lasting 4 hours or more) from ADHD drugs, including Ritalin and Concerta. The problem is that these drugs are commonly prescribed to children, who are less likely to report priapism or seek medical attention.
What is Priapism?
Priapism is a medical condition involving an unwanted erection of the penis lasting 4 hours or more. It is not caused be sexual stimulation or arousal, but rather trapped blood in the penis. The condition is uncommon but very serious because it can cause permanent sexual dysfunction.
Priapism and Erectile Dysfunction
Without emergency medical treatment, tissue in the penis can be damaged and cause permanent erectile dysfunction (inability to get or maintain an erection). The problem is that priapism is a side effect of ADHD drugs, which are commonly prescribed to children. Young men, especially pre-adolescents, are less likely to recognize symptoms or report them to an adult due to embarrassment. Delayed treatment increases the risk of erectile dysfunction.
FDA Warning for ADHD Drugs and Priapism
December 17, 2013 — The U.S. Food and Drug Administration (FDA) has identified 15 cases of priapism associated with ADHD medications in the methylphendate class. They have issued a Drug Safety Communication and updated the warning label on these medications. The cases were reported between 1997 and 2012, and most involved children (median age 12.5 years). Hospitalization was necessary for some patients, including two who needed surgical treatment. Click here to read more.
ADHD Drugs Linked to Priapism
The following is a partial list of drugs that have been associated with Priapism. The FDA is concerned about the following ADHD drugs and priapism:
- Concerta
- Daytrana
- Focalin / Focalin XR
- Metadate CD / Metadate ER
- Ritalin / Ritalin LA / Ritalin SR
- Methylin / Methylin ER
- Quillivant XR
List of Medications Linked to Priapism
UCSF Health has also provided a list of other drugs associated with priapism:
- Erectile dysfunction drugs
- Antidepressants
- Bupropion
- Trazodone
- Fluoxetine
- Sertraline and lithium
- Desyrel
- Antipsychotics
- Clozapine
- Antianxiety Agents
- Hydroxyzine
- Psychotropics
- Chlorpromazine
- Alpha-adrenergic Blocker
- Prazosin
- Hormones
- Gonadotropin-releasing hormone (in hypogonadal men)
- Testosterone
- Anticoagulants
- Heparin
- Coumadin
Treatment for Priapism
Application of ice to the penis can sometimes reduce swelling and pain in the penis. However, in many cases, surgery is necessary to restore normal blood-flow to the penis. If an artery has become too wide, injection drugs may be used to narrow the artery. If the artery has ruptured, doctors must tie it off to stop bleeding or implant a shunt to divert blood-flow. Doctors may also use a technique called aspiration to drain blood from the penis, reduce pressure, and alleviate swelling.