Retrograde ejaculation associated with quetiapine and treatment with low-dose imipramine

Abstract

Sexual side-effects are common among those using antipsychotic medication and may result in poor compliance and reduced quality of life. Retrograde ejaculation (RE) has been described occurring with a number of antipsychotic medications (thioridazine, risperidone, iloperidone and clozapine) but there are no guidelines regarding management of antipsychotic-associated RE. Imipramine has been suggested as a treatment for antipsychotic-associated RE in one small study of patients prescribed thioridazine and a case series of patients prescribed iloperidone. Quetiapine is a commonly used antipsychotic and is thought to be associated with less sexual side-effects relative to other antipsychotic medications. This case report describes a 25-year-old man with first episode psychosis who developed RE during treatment with quetiapine which improved with low-dose imipramine. This is the first description of RE occurring with quetiapine and successful treatment of quetiapine-associated RE with imipramine.

Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach

“…Other small observational studies and cases series also suggest improvement of TESD with the addition of imipramine at lower doses (25–50 mg/day) [ 187 , 188 ], mirtazapine (30 mg/day) [ 189 ], saikokaryukotsuboreito (Herbal Medicine) [ 190 ], and pramipexol (0.25 mg) [ 191 ].…”

Semen collection by urethral catheterization and electro-ejaculation with different voltages, and the effect of holding temperature and cooling rate before cryopreservation on semen quality in the Japanese macaque (<i>Macaca fuscata</i>)

“…Detomidine and xylazine, which are other α2-agonists, were used for pharmacological semen collection from stallions in combination with imipramine and oxytocin [ 5 , 47 ]. The sympathetic effect of imipramine [ 15 , 36 ] and promotion of sperm fluid from the epididymis with oxytocin [ 32 ] may assist semen collection. Therefore, UC protocols using other pharmacological stimulations should be investigated since the effect of these drugs is unclear for the Japanese macaque.…”

A Comprehensive Guide to Sperm Recovery in Infertile Men with Retrograde Ejaculation

“…Neuropathy resulting from nerve damage secondary to uncontrolled diabetes, multiple sclerosis, non-nerve sparing retroperitoneal lymph node dissection or spinal cord injury could lead to a functional bladder neck closure incompetency [ 2 ]. Pharmacologically mediated bladder neck dysfunction is another common cause for RE and may include; effects of medications used to treat benign prostatic hyperplasia (BPH) such as such as alpha blockers tamsulosin, alfuzosin, or terazosin; mood disorders such as selective serotonin reuptake inhibitors including fluoxetine and sertraline among several others; antipsychotics - such as chlorpromazine, thioridazine, and risperidone [ 2 11 ]. There has been more evidence that many alpha blockers may not be causing RE but rather lack of emission or anejaculation [ 7 12 ].…”