Alprazolam-induced dose-dependent anorgasmia: case analysis
| Autor: | Michelle Linke, Ronke Babalola, Kenneth R. Kaufman, Elizabeth Noonan, Rehan Aziz, Melissa Coluccio |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pediatrics
medicine.medical_specialty Gabapentin clinical care medicine.drug_class obsessive–compulsive disorder attention-deficit hyperactivity disorder Context (language use) anorgasmia 03 medical and health sciences 0302 clinical medicine adverse effect medicine Escitalopram Adverse effect Benzodiazepine education Alprazolam nonadherence business.industry 030227 psychiatry Psychiatry and Mental health anxiety disorder major depressive disorder Sexual dysfunction sexual dysfunction Papers Nortriptyline medicine.symptom benzodiazepine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BJPsych Open |
| ISSN: | 2056-4724 |
| Popis: | BackgroundSexual dysfunctions are associated with multiple medical and psychiatric disorders, as well as pharmacotherapies used to treat these disorders. Although sexual dysfunctions negatively affect both quality of life and treatment adherence, patients infrequently volunteer these symptoms and clinicians do not pose directed questions to determine their presence or severity. This issue is especially important in psychiatric patients, for whom most common psychotropics may cause sexual dysfunctions (antidepressants, antipsychotics, anxiolytics and mood-stabilising agents). There is limited literature addressing benzodiazepines, and alprazolam in particular.AimsTo report dose-dependent alprazolam anorgasmia.MethodCase analysis with PubMed literature review.ResultsA 30-year-old male psychiatric patient presented with new-onset anorgasmia in the context of asymptomatic generalised anxiety disorder, social anxiety, panic disorder with agoraphobia, obsessive–compulsive disorder, major depression in remission, and attention-deficit hyperactivity disorder treated with escitalopram 10 mg q.a.m., gabapentin 1000 mg total daily dose, lisdexamfetamine dimesylate 70 mg q.a.m., nortriptyline 60 mg q.h.s. and alprazolam extended-release 2.5 mg total daily dose. All psychotropic doses had been constant for >6 months excluding alprazolam, which was titrated from 1 mg to 2.5 mg total daily dose. The patient denied any sexual dysfunction with alprazolam at 1 mg q.d. and 1 mg b.i.d. Within 1 week of increasing alprazolam to 2.5 mg total daily dose, the patient reported anorgasmia. Anorgasmia was alprazolam dose-dependent, as anorgasmia resolved with reduced weekend dosing (1 mg b.i.d. Saturday/1.5 mg total daily dose Sunday).ConclusionsSexual dysfunction is an important adverse effect negatively influencing therapeutic outcome. This case reports alprazolam-induced dose-dependent anorgasmia. Clinicians/patients should be aware of this adverse effect. Routine sexual histories are indicated.Declaration of interestNone. |
| Databáze: | OpenAIRE |
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