Significant improvement of risperidone-induced retrograde ejaculation on drug holidays: a case report

Abstract

Risperidone, which is one of the most commonly prescribed second-generation antipsychotics can cause several sexual adverse effects. To date, research on the sexual side effects of risperidone has been mostly restricted to symptoms of decreased libido, erectile dysfunction and delayed ejaculation and far too little attention has been paid to risperidone associated retrograde ejaculation. What is not clear is that whether this side effect appears in a dosedependent manner and whether structured treatment interruptions/drug holidays can diminish sexual adverse effects without a reduction in treatment efficacy. Another question is whether concurrent use of opiates and risperidone can increase the risk of retrograde ejaculation due to their anticholinergic and adrenergic blocking properties. Here we describe a case of a 30-year-old male with schizophrenia and opium dependence who developed risperidone-induced retrograde ejaculation; however, the ejaculatory dysfunction improved significantly on drug holidays. This is the first report on the use of structured treatment interruptions in the management of risperidone-induced retrograde ejaculation. ARTICLE HISTORY

The effect of drug holidays on sexual dysfunction in men treated with selective serotonin reuptake inhibitors (SSRIs) other than fluoxetine: an 8-week open-label randomized clinical trial

“…Buspirone (5-HT1A receptor partial agonist) can cause dizziness, nausea, and headaches. Bupropion (norepinephrine and dopamine agonist) can cause insomnia, agitation, and increased heart rate [ 3 – 9 , 24 ].…”

“…Drug holidays is defined as temporarily stopping or reducing the dose of medication. It has previously been used to help alleviate side effects or improve the effectiveness of the primary medication for the treatment of various mental disorders [ 9 , 10 ].…”

Safety and Efficacy of Drug Holidays for Women with Sexual Dysfunction Induced by Selective Serotonin Reuptake Inhibitors (SSRIs) Other than Fluoxetine: An Open-Label Randomized Clinical Trial

“…Drug holidays involves temporarily discontinuing or reducing the medication dosage to alleviate the associated side effects. Drug holidays has specifically been recommended for delayed orgasms and anorgasmia [5][6][7][8][9]. However, research in this area is limited, with only one 4-week clinical trial reporting significant improvement of sexual function, without any significant changes in depressive symptoms, except in those receiving fluoxetine, possibly due to fluoxetine's long half-life [8,9].…”