Vol. 7, Issue 1, Part A (2025)

Serotonin norepinephrine reuptake inhibitors (SNRIs) are widely used in the treatment of obsessive-compulsive and depressive disorders. While sexual side effects such as delayed ejaculation and decreased libido are well documented. Priapism remains a rare and underreported adverse effect. Recognizing this side effect is critical to ensure treatment adherence and prevent complications. A 46-year-old man with obsessive-compulsive disorder experienced recurrent priapism associated with venlafaxine use, leading to poor adherence and repeated symptom relapse. Delayed disclosure of this adverse effect contributed to prolonged treatment disruption. This case stresses the importance of considering rare sexual side effects such as nocturnal priapism in patients treated with SNRIs, particularly when medication adherence is unexpectedly poor. Proactive, nonjudgmental inquiry into sexual health and side effects can help identify barriers to treatment and guide safer, more acceptable pharmacologic strategies.