Priapism as a rare adverse effect of levomepromazine: A case report

Table 1 Clinical characteristics, management, and outcomes of previously reported levomepromazine-associated priapism compared with the present case

Study	Age/context	Levomepromazine exposure	Concomitant drugs	Previous priapism	Onset	Presentation	Management/outcome
Brichart et al[5], 2008	44/paranoid schizophrenia	50 mg/day	Zuclopenthixol	Yes (olanzapine, clozapine)	NR	Recurrent ischemic priapism; 2 episodes < 24 hours	Aspiration-irrigation + IC sympathomimetic; successful detumescence
Brichart et al[5], 2008	25/major depressive disorder	50 mg/day	Other medications1	NR	NR	Ischemic priapism, approximately 12 hours	Aspiration-irrigation + IC phenylephrine; successful detumescence; lost to follow-up
Stefanini et al[6], 2025	NR/psychiatric hospitalization	Dose NR	Thiamine + lorazepam	Yes2	8 days	Painful priapism > 4 hours; recurrence after 2 days	Drainage → surgical treatment; medication changed
Stefanini et al[6], 2025	NR/psychiatric hospitalization	75 → 100 mg/night	Recent benzodiazepine withdrawal	No reported history	1 day after dose increase	Priapism; duration NR	Conservative management; dose reduced to 75 mg; no recurrence reported
Present case	45/schizophrenia	100 mg/day (25 mg × 4)	None	No	48 hours	Painless ischemic priapism, 8 hours; pH 6.831, PO2 8, PCO₂ 84 mmHg	IC phenylephrine → Quackels shunt; immediate complete detumescence; discharge D2

¹Other concomitant medications were reported, but were not considered priapism-inducing by the authors.

²Previous episode was disclosed after recurrence.

IC: Intracavernosal; NR: Not reported; PO₂: Partial pressure of oxygen; PCO₂: Partial pressure of carbon dioxide.