Reactions 1539, p74 - 21 Feb 2015 1

Bupropion/trazodone S

Clitoral priapism: case report

A 29-year-old woman developed clitoral priapism after
receiving with bupropion [Wellbutrin] and trazodone for low
libido as part of a clinical trial.
The woman presented with a 5-day history of significant
progressive clitoral pain; she had a history of Hashimoto’s
thyroiditis. She was enrolled in a clinical trial for low libido,
4 months earlier and was administered daily bupropion and
trazodone [routes and dosages not stated]. One day prior to
the onset of pain, her trazodone dosage was increased; she
was then instructed to discontinue bupropion and trazodone.
After withdrawal of bupropion and trazodone, the woman
experienced progressive labial swelling over 5 days with
throbbing pain in the clitoral area. Debilitating pain was
associated with sitting, walking and standing. Examination
revealed a firm, palpable, tender corpora, bilaterally, with an
oedematous, firm clitoris, 2.0 x 0.7cm in size; the clitoris
exhibited purple discolouration and was very tender on
palpation. Ice and pseudoephedrine was initiated with slight
improvement. Vicodin and motrin were administered; after
24 hours, a significant reduction in clitoral swelling was
observed and her pain was tolerable. She returned home after
48 hours; her symptoms fully resolved 3 days after discharge.
At follow-up, no sexual dysfunction was reported.
Author comment: "Female clitoral priapism is a rare
condition. There are few case reports describing the
condition, and those cite psychotropic medications such as
trazodone, buproprion, and SSRIs as the most common
causative agents."
Unger CA, et al. Female clitoral priapism: an over-the-counter option for
management. Journal of Sexual Medicine 11: 2354-2356, No. 9, Sep 2014 -
USA 803114265

0114-9954/15/1539-0001/$14.95 Adis © 2015 Springer International Publishing AG. All rights reserved Reactions 21 Feb 2015 No. 1539