Objective: To describe reversible rotigotine – induced priapism and hypersexuality in a 79-year-old left-handed male with Parkinson’s disease (PD).

Background: Priapism is a urological emergency defined as persistent and painful penile erection that is unrelated to sexual stimulation. Priapism is commonly associated with iatrogenic, pharmacologic, underlying medical, or traumatic causes. It can occur as a side effect of several classes of medication: antihypertensives, anticoagulants, alpha-blockers, antidepressants and antipsychotics.

Methods: We present the case of a 79-year-old left-handed male with PD who developed 12 hours of persistent erection and compulsive sexual behavior after few hours of therapy with rotigotine 4mg/24h.

Results: After complete withdrawal of rotigotine, both priapism and hypersexuality were dramatically resolved within 2 hours.

Conclusions: We speculate a different mechanism related to rotigotine-induced priapism that, unlike antipsychotics, involve sexual reward by the dopamine D1, D2 and D3 receptors. This case underscored the importance of investigation of dopamine agonist-induced priapism in patients presenting with hypersexual behaviour. In our opinion, the co-occurrence of priapism and hypersexuality in patients taking dopamine agonists is underestimated.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/priapism-and-hypersexuality-associated-with-rotigotine-in-an-elderly-parkinsonian-patient-a-case-report/