Spontaneous ejaculation with the use of ADHD drugs
| Jazyk: | angličtina |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
ejaculation
noradrenalin drug surveillance program dexamphetamine adverse drug reaction latent period attention deficit disorder muscle cramp methylphenidate milnacipran amphetamine derivative male zotepine case report psychiatrist micturition risk Netherlands physician reboxetine consumer noradrenalin uptake inhibitor serotonin drug therapy adrenergic activity fatigue patient dopamine atomoxetine |
| DOI: | 10.2165/11316660-000000000-00000 |
| Popis: | Background: Methylphenidate and atomoxetine are indicated for treatment of attention deficit-hyperactivity disorder (ADHD). The Netherlands Pharmacovigilance Centre Lareb received two reports of spontaneous ejaculation associated with the use of these drugs. Objective: To describe two case reports of spontaneous ejaculation associated with the use of methylphenidate and atomoxetine. In addition, a suggestion for a possible mechanism is provided. Methods: A search of spontaneous reports received by the Netherlands Pharmacovigilance Centre Lareb between January 1996 and May 2009. Medline search of the published literature. Results: Lareb received two reports of spontaneous ejaculation associated with the use of these drugs. The first report from a psychiatrist concerns a 40-year-old male who receives atomoxetine for ADHD. Three weeks after start, he develops spontaneous ejaculations following micturition urgency up to eight times a day. There were no sexual feelings. In the past, the patient used dexamphetamine, which gave also spontaneous ejaculations. The patient recovered after dexamphetamine and atomoxetine withdrawal. Concomitant medication is not reported. The second report from a consumer concerns a 25-year-old male who experiences spontaneous ejaculation following testicular cramps after micturition with the use of methyl- phenidate. Sexual feelings are not present. The spontaneous ejaculations are mainly present in times of stress and fatigue. Concomitant medication is not reported. Past drug therapy included atomoxetine which gave also spontaneous ejaculations following micturition. At the time of reporting, the patient is still using methylphenidate and is still having testicular cramps and spontaneous ejaculations. Discussion: Atomoxetine is a norepinephrine reuptake inhibitor. Methylphenidate and dexamphetamine are amphetamines, who act as reuptake inhibitors of norepinephrine, serotonin and dopamine. The exact mechanism of these drugs on ADHD is not clear.[1] Ejaculation is a complex mechanism with a central and peripheral pathway. The peripheral pathway is adrenergic and mainly facilitated by norepi- nephrine. Also, adrenergic activity may decrease ejaculatory latency and induce spontaneous ejaculation.[2] Through the inhibition of the reuptake of noradrenalin spontaneous ejaculation can occur. In literature, a few cases are described concerning spontaneous ejaculation with the use of milnacipran,[3] reboxetine[2] and zotepine[4] due to a norepinephrine-reuptake effect. Conclusion: The two case reports illustrate a new possible adverse drug reaction of spontaneous ejaculations with the use of methylphenidate and atomoxetine which may be mediated by to the re-uptake inhibition of norepinephrine. Physicians should be aware of the possibility of these drugs to cause spontaneous ejaculations. |
| Databáze: | OpenAIRE |
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