Abstract
The case of a patient with sleep-related painful erections is described. Insomnia and a slight depressive syndrome occurred along with a long history of this disorder. No physical abnormality was found. At a baseline recording of sleep electroencephalography (EEG) and nocturnal penile tumescence (NPT), a disturbed sleep pattern and impaired NPT were recorded. Attempts to treat the disorder with diazepam, amitriptyline, trimipramine, and biperidene did not prompt a stable improvement of the disorder, but a dosage of 25 mg clozapine was sufficient to achieve normalized sleep architecture, remission of the depressive symptomatology, and normalization of NPT. It is likely that marked sedation is the mode of action of clozapine.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association. (1980).Diagnostic and Statistical Manual of Mental Disorders (3rd ed.), APA, Washington, DC.
Angst, J., Bente, D., Berner, P., Heimann, H., Helmchen, H., and Hippius, H. (1971). Das klinische Wirkungsbild von Clozapin (Untersuchung mit dem AMP-System).Pharmakopsychiat. Neuropsychopharmakol. 4: 201–211.
Association of Sleep Disorders Centers and the Association for the Psychophysiological Study of Sleep. (1979). Diagnostic classification of sleep and arousal disorders, First Edition.Sleep 2: 5–137.
Karacan, I. (1971). Painful nocturnal penile erections.J. Am. Med. Assoc. 215: 1831.
Karacan, I., Goodenough, D. R., Shapiro, A., and Staker, S. (1966). Erection cycle during sleep in relation to dream anxiety.Arch. Gen. Psychiat. 15: 183–189.
Karacan, I., and Ilaria, R. L. (1978). Nocturnal penile tumescence (NPT): The phenomenon and its role in the diagnosis of impotence.Sex. Disabil. 1: 260–271.
Matthews. B. J., and Crutchfield, M. B. (1987). Painful nocturnal penile erections associated with rapid eye movement sleep.Sleep 10: 184–187.
Spitzer, R. L., and Williams, J. B. W. (1984). Interview: Structured clinical interview for DSM-III. Patient version (Revision from 1.5.1984).
Steiger, A. (1988). Effects of clomipramine on sleep-EEG and nocturnal penile tumescence (NPT), a long-term study in a healthy man.J. Clin. Psychopharmacol. 8: 349–354.
Steiger, A., Holsboer, F., Benkert, O. (1987). Effects of brofaromine (CGP 11 305A), a shortacting, reversible, and selective inhibitor of MAO-A on sleep, nocturnal penile tumescence and nocturnal hormonal secretion in three healthy volunteers.Psychopharmacology 92: 110–114.
von Bardeleben, U., Steiger, A., Gerken, A., and Holsboer, F. (1986). Pharmacoendocrine and sleep-EEG characteristics of fluoxetine in normal controls.Br. J. Clin. Pract. 40(Suppl. 46): 34–40.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steiger, A., Benkert, O. Examination and treatment of sleep-related painful erections—a case report. Arch Sex Behav 18, 263–267 (1989). https://doi.org/10.1007/BF01543200
Issue Date:
DOI: https://doi.org/10.1007/BF01543200