piperidines and Capgras-Syndrome

This case series describes the development of retrograde ejaculation with the antipsychotic iloperidone. Iloperidone is a relatively new antipsychotic and has a strong α-1 receptor antagonism, which may explain this rare adverse effect.

Topics: Antipsychotic Agents; Capgras Syndrome; Ejaculation; Humans; Isoxazoles; Male; Piperidines; Schizophrenia; Sexual Dysfunctions, Psychological; Young Adult

We report the case of a patient who presented visual hallucinations and identification disorders associated with a Capgras syndrome. During the Capgras periods, there was not only a misidentification of his wife's face, but also a more global perceptive and emotional sexual identification disorder. Thus, he had sexual intercourse with his wife's "double" without having the slightest recollection feeling of familiarity towards his "wife" and even changed his sexual habits. To the best of our knowledge, he is the only neurological patient who made his wife a mistress. Starting from this global familiarity loss, we discuss the mechanism of Capgras delusion with reference to the role of the implicit system of face recognition. Such behavior of familiarity loss not only with face but also with all intimacy aspects argues for a specific disconnection between the ventral visual pathway of face identification and the limbic system involved in emotional and episodic memory contents.

Topics: Aged; Amnesia; Antipsychotic Agents; Atrophy; Brain; Capgras Syndrome; Donepezil; Hallucinations; Humans; Indans; Male; Memory; Movement Disorders; Neuropsychological Tests; Nootropic Agents; Parkinsonian Disorders; Piperidines; Recognition, Psychology; Risperidone; Sexual Behavior; Spouses; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed