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Spontaneous Ejaculations Associated with Aripiprazole.
Oğuzhan Eğilmez1, Mustafa Çelik1, Aysun Kalenderoğlu1
1Department of Psychiatry, Adıyaman University School of Medicine, Adıyaman, Turkey.
Noro Psikiyatri Arsivi
|April 1, 2017
Summary
Antipsychotic medications can cause sexual side effects. This case study details spontaneous ejaculations in a patient switching from risperidone to aripiprazole, resolving with dose reduction.
Area of Science:
- Neuroscience
- Pharmacology
- Psychiatry
Background:
- Sexual side effects are a known concern with antipsychotic medications.
- Spontaneous ejaculations, unrelated to sexual arousal, have been documented with various antipsychotics.
Observation:
- A patient experienced spontaneous ejaculations after discontinuing risperidone and initiating aripiprazole at 30 mg/day.
- The spontaneous ejaculations resolved within three days of reducing the aripiprazole dosage to 15 mg/day.
- The patient reported no concurrent sexual fantasies or increased libido.
Findings:
- Aripiprazole's partial agonism at dopamine D2 receptors may have reactivated the mesolimbic dopaminergic pathway, previously suppressed by risperidone.
- Serotonergic effects of aripiprazole could also contribute to this unusual side effect.
- This suggests a potential interaction between antipsychotics with different dopaminergic profiles.
Implications:
- Clinicians should inquire about spontaneous ejaculations in patients prescribed aripiprazole, especially after treatment with D2-blocking antipsychotics.
- Recognizing and addressing this side effect is crucial to prevent patient embarrassment and improve treatment compliance.
- Further investigation into the neuropharmacological mechanisms underlying this adverse event is warranted.