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While experts say priapism linked to ADHD medication is rare, it’s important enough for the FDA to now require a warning label. This possible side effect should accompany prescriptions that carry the greatest risk.
If you or your son take medication to help ease the symptoms of ADHD, you should know what the risk means.
What Priapism Is
When a healthy erection happens, sexual stimulation, either physical or psychological, causes blood to flow into the penis, where it’s temporarily blocked from leaving. With priapism, there may or may not be any sexual stimulation, and blood cannot flow back out of the penis like it should.
You’ve probably heard the warning that accompanies some erection health medications. It explains that an erection lasting more than four hours is dangerous, and should be reported to your doctor. The reason for this warning is tissue damage.
When blood can’t flow back out of the penis, permanent tissue damage can occur partly because the blood that is trapped isn’t oxygenated. The damage from trapped blood can cause so much tissue damage, it may affect your ability to achieve and maintain an erection in the future, and can cause disfigurement.
ADHD medications aren’t the only cause of priapism. The blood, blood vessels, or nerves that normally participate in causing an erection can also be at fault.
Blood disorders, such as sickle cell anemia and leukemia, are one potential cause. Antidepressants, blood thinners, alcohol, recreational drugs, and injury can also be at fault in some men.
If you experience an erection that doesn’t resolve on its own, you should seek medical attention right away. Mayo Clinic also says an erection lasting more than 4 hours that does resolve on its own also merits a doctor’s advice.
Which ADHD Medications are Riskier
Not all ADHD medications are cause for concern. The central nervous system stimulants, Methylphenidates, are one class to watch. This includes Ritalin, Concerta, Daytrana, Focalin, Metadate, Methylin, and Quillivant. However, the non-stimulant drug, Strattera might be the riskiest of all. Reports to-date show more incidence of priapism in patients who take Strattera than any other ADHD drug.
Because these medications are often prescribed to children under the age of 18, priapism has been reported in young boys. The median age, according to the FDA, is 12.5 years, with the youngest at 8 years and the oldest at 33 years.
Two of many issues with priapism occurring in young boys who haven’t reached puberty are not recognizing it as a problem, and embarrassment and reluctance to talk about it. WebMD says doctors encourage parents to know the signs and seek immediate medical attention if necessary.
Treatment for Priapism
The American Urological Association says priapism is a medical emergency. This is why erection health drug warnings say seek medical attention immediately for an erection lasting for more than 4 hours.
Not all cases are an actual emergency, but there is no way for you to know the cause if it happens to you. Most men and boys who take ADHD medications do not develop priapism. So if you do, your medication may or may not be the problem behind it.
The goals of immediate treatment are to reduce the erection as fast as possible and preserve erectile function; failing to seek emergency help could result in the permanent inability to achieve an erection.
Your doctor may order a blood toxicology report and radiography as part of the treatment. Depending on the severity, he may aspirate the trapped blood from the penis, inject a medication that helps blood leave the penis through the usual vessels, or both. In some cases, oral medication might be used to correct the problem.
Priapism is very uncommon, so there’s no cause for alarm. But the severity of this condition when it does happen means you need to act quickly if you recognize the signs in yourself or young son. Because of the sensitivity of the topic, you might also consider explaining to your son the signs to watch out for, and to tell you immediately if he experiences them.
ADHD medications are by and large safe and effective. You don’t necessarily need to ask about an alternative treatment, and definitely don’t stop taking medication without the advice of your doctor.
Chances are you’ll never experience priapism. But if you do, you’ll know the signs and understand how critical it is to get emergency help right away.
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