Risperidone-associated ejaculatory and urinary dysfunction in male adolescents.
We report two male adolescents who developed partial or complete retrograde ejaculation during risperidone treatment. Additionally, one patient complained of bladder outflow obstruction, and the other reported a reduced ejaculatory volume and decreased viscosity of semen. On rechallenge with risperidone, patient A showed a prompt recurrence of the ejaculatory dysfunction. The side effects were highly disturbing and led to reduced treatment compliance in both patients. The impact of risperidone, a strong alpha(1)-receptor antagonist, on the adrenergic system might induce retrograde ejaculation by altering the sympathetic tonus, allowing semen to pass retrogradely into the bladder during ejaculation. The reduced ejaculatory volume may be caused by risperidone-induced hyperprolactinemia. Clinicians should regularly inquire about sexual dysfunction and symptoms suggestive of hyperprolactinemia before starting risperidone treatment and regularly thereafter.
Holtmann
Martin
M
Central Institute of Mental Health, Department of Child and Adolescent Psychiatry and Psychotherapy, PO Box 12 21 20, D-68072 Mannheim, Germany. holtmann@zi-mannheim.de
Gerstner
Sandra
S
Schmidt
Martin H
MH
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced; D008297:Male; D018967:Risperidone / Q000009:adverse effects*; D012559:Schizophrenia / Q000188:drug therapy*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*; D014555:Urination Disorders / Q000139:chemically induced*
D014150:Antipsychotic Agents; D018967:Risperidone