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Paliperidone as an Alternative for Risperidone in a Case of Schizophrenia With Retrograde Ejaculation
Arun Kandasamy
The Journal of Neuropsychiatry and Clinical Neurosciences 2012;24:10017-10018. 10.1176/appi.neuropsych.11070150
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Assistant Professor Department of Psychiatry National Institute of Mental Health and NeuroSciences Bangalore, India email: arunnimhans05@gmail.com

Extract

To the Editor: Risperidone is an atypical antipsychotic agent. Compared with other antipsychotics, risperidone is a potent α1 adrenoreceptor antagonist, with a high affinity (Ki of 0.69).1 There are specific adverse effects of this property. Significant among them is retrograde ejaculation.25 The impact of risperidone, a strong α1-receptor antagonist, on the adrenergic system might induce retrograde ejaculation by altering sympathetic tonus, allowing semen to go retrograde into the bladder during ejaculation. The management of antipsychotic drug-induced sexual dysfunction is primarily directed toward avoiding the mechanism of the adverse effect, whether it is prominent dopamine blockade, elevated prolactin levels, or α-adrenergic blockade.4 Here, a case of risperidone-induced retrograde ejaculation that was successfully managed with paliperidone (9-OH risperidone) is presented.

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