From the FDA Drug Label
Priapism has been reported with all SSRIs. Autonomic Nervous System Disorders-Rare: priapism, The answer is: Zoloft (sertraline), as it is an SSRI and priapism has been reported with all SSRIs 1.
- Zyrtec (cetirizine) and gabapentin are not mentioned in the context of priapism in the provided drug labels. There is no information to suggest that Zyrtec (cetirizine) or gabapentin can cause priapism based on the provided drug labels.
From the Research
Zoloft (sertraline) is the medication most associated with priapism among the options listed, due to its effects as a selective serotonin reuptake inhibitor (SSRI) on serotonin levels, which can influence blood flow and vascular function in penile tissue. Priapism is a prolonged, often painful erection that lasts for more than four hours without sexual stimulation. While this side effect is rare with Zoloft, it has been documented in medical literature 2. Neither Zyrtec (cetirizine), an antihistamine, nor gabapentin, an anticonvulsant and nerve pain medication, are typically associated with priapism as a side effect.
The mechanism behind priapism involves the blockade of alpha1-adrenergic receptors in the corpora cavernosa, which can lead to persistent erections 3, 4. However, SSRIs like Zoloft can also influence serotonin levels, potentially affecting blood flow and contributing to priapism. It's crucial for patients taking any medication to be aware of the risk of priapism and seek immediate medical attention if they experience a prolonged erection, as it constitutes a medical emergency that can lead to permanent erectile dysfunction if left untreated.
Key points to consider:
- Priapism is a medical emergency requiring prompt treatment to prevent long-term complications.
- Zoloft (sertraline) has been associated with priapism due to its SSRI effects.
- Patients should be educated about the risks of priapism and the importance of seeking immediate medical attention if symptoms occur.
- The management of priapism involves addressing the underlying cause and may include treatments such as aspiration/irrigation, sympathomimetic injections, or surgical interventions in severe cases 5, 6.