piperidines and Sexual-Dysfunctions--Psychological

As cholinergic mechanisms may be at least partially responsible for hallucinations and delusions in Parkinson's disease (PD), we conducted an open study in 8 PD patients to assess the efficacy and tolerability of the cholinesterase inhibitor donepezil, 5 mg at bedtime for two months, in the treatment of these complications. Hallucinations and delusions improved significantly in all patients. Donezepil was overall well tolerated, but a deterioration in motor disability was noted in 2 out of 8 patients.

Topics: Aged; Aged, 80 and over; Basal Nucleus of Meynert; Cholinergic Fibers; Cholinesterase Inhibitors; Delusions; Donepezil; Female; Hallucinations; Humans; Indans; Male; Movement; Parkinson Disease; Piperidines; Sexual Dysfunctions, Psychological; Sleep Wake Disorders; Treatment Outcome

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

Hypersexuality in Alzheimer's disease (AD) has been rarely investigated. Hypersexual behaviours should be classified as a sexual obsession and included in the "obsessive-compulsive disorder-like" spectrum. Hypersexuality has no proven treatment, although reports have described reductions of this behaviour using antiandrogen treatment, H2-receptor antagonists and antipsychotic drugs. Serotonin reuptake blockers seem to be effective in the treatment of sexual obsessions or compulsions and less on paraphilic disturbances. We present the case of a 54-year-old male patient with Alzheimer's disease with compulsive sexual behaviour as reported by his wife. A 18-FDG PET scan evidenced prevalent hypometabolism of the right hemisphere, congruent with neuropsychological evaluation. Donepezil, 10 mg per day, produced cognitive improvement but no effects on sexual behaviour. Therapy with SSRI was subsequently started (citalopram): after 60 days, the patient showed improvement in both the compulsive pursuit of sex acts and the level of frustration when refused.

Topics: Alzheimer Disease; Brain; Citalopram; Cognition Disorders; Disease Progression; Donepezil; Fluorodeoxyglucose F18; Humans; Indans; Male; Memory Disorders; Middle Aged; Mood Disorders; Nootropic Agents; Obsessive-Compulsive Disorder; Piperidines; Positron-Emission Tomography; Selective Serotonin Reuptake Inhibitors; Serotonin; Sexual Behavior; Sexual Dysfunctions, Psychological; Treatment Outcome