Association Between Mirtazapine Use and Priapism in a Middle-Aged Man: A Case Report

A 43-year-old man presented with three episodes of priapism in 4 weeks following testosterone replacement therapy and mirtazapine use. He previously had a two-episode history of priapism 5 years ago after taking trazodone. The exact mechanism for mirtazapine-induced priapism is unclear. However, the timing of the patient's priapism onset suggests that mirtazapine was driving these episodes. Given the unusual circumstances of this case, there may be patient-specific risk factors for recurrent priapism, such as a history of priapism. Therefore, careful use of mirtazapine is advised in patients with previous episodes of priapism. Furthermore, men taking mirtazapine should be informed of the signs and symptoms of priapism and advised to seek medical attention if they experience prolonged erections. [ Psychiatr Ann . 2023;53(10):482–484.]