BRC monitors the use of the CRIS database and patients are able

to opt out of the CRIS database if they choose. We found 13 cases of reported priapism between 2000 and 2010, 6 in patients taking risperidone (3 as monotherapy and 3 in combination with other drugs). Five cases were associated with trazodone, 1 with paroxetine, 1 with clozapine and citalopram (Table Inhibitors,research,lifescience,medical 2). Table 2. South London and Maudsley patients review. In the UK, 37 cases of priapism in patients taking risperidone have been reported so far to the Medicines and Healthcare Products Regulatory Agency since the drug was licensed in 1992 (including the case described in this paper), with a total number of 7961 reactions reported in patients on risperidone. It is difficult to draw a typical risk

profile from these EPZ5676 in vitro findings. However, it seems priapism Inhibitors,research,lifescience,medical can occur at any time from a few days following initiation of treatment up to 2 years. The age of those affected ranged from 13 to 65, although in a majority of cases, patients were in their 30s, 40s and 50s. Inhibitors,research,lifescience,medical The most striking feature of this review is the ethnic background of the patients. Out of 32 cases described in the literature, the ethnic group was known for 14 patients, 8 of which were of African-Caribbean origin, 4 were Hispanic. Out of the six cases identified at SLAM, four were of African-Caribbean origin, a population group more likely to be on antipsychotic medication [Bresnahan et al. 2007; Fearon et al. 2006; Kirkbride et al. 2006; Xanthos, Inhibitors,research,lifescience,medical 2008]. It is also worth noting that SLAM serves a migrant multiethnic catchment area, with a significant black African–Caribbean population, which undoubtedly contributes to this community being over represented in our small sample. We are not aware from our literature review of any described genetic predisposition in the black population with the exception of sickle cell disease, which is the Inhibitors,research,lifescience,medical most common cause in children [Adeyoju et al. 2002] and to a lesser extent sickle cell trait [Adeyoju et

al. 2002; Birnbaum and Pinzone, 2008; Larocque and Cosgrove, 1974]. Unfortunately not all published case reports report whether sickle cell Endonuclease disease or trait was present. Among atypical antipsychotics, risperidone and ziprasidone have the highest affinity for α-adrenergic receptors [Andersohn et al. 2010] and have been associated with several cases of priapism, both when administered as a monotherapy or in combination with other drugs [Brichart et al. 2008; Sood et al. 2008]. α-Adrenergic receptors have a significant role in physiologic erectile function and classes of drugs with α-adrenergic antagonistic properties can cause priapism [Horowitz and Goble, 1979; Traish et al. 2000] by inhibiting the process that causes penile detumescence [Spagnul et al. 2011].