Two Cases of Hypersexuality Probably Associated with Aripiprazole
Ms. A was a 37-year-old female patient with schizophrenia, paranoid type. She has a history of multiple relapses with poor compliance requiring recurrent admissions. She was admitted to our university hospital with delusions of reference and persecution, and risperidone 5 mg/day was administered to her. After one year, she experienced galactorrhea and amenorrhea. Subsequently her medication was changed to 10 mg/day of aripiprazole, then to 20 mg/day. Her positive symptoms decreased after this dosage increase, but her libido increased within a month after this dosage increase. Her hypersexuality was exhibited by 1) demand for daily sexual intercourse, 2) frequent use of online pornography. These behaviors had never been exhibited prior to her aripiprazole therapy. Routine physical examination and laboratory investigations were all within normal limits. We discontinued aripiprazole therapy and prescribed risperidone 0.5 mg/day but the patient was lost to follow-up.\n5 months later, Ms A was hospitalized for a psychotic episode with delusion of infidelity. She was treated with quetiapine 800 mg/day. After two months, she was discharged from our hospital. We have no report of an increased demand for sexual relations on her part, and her delusion of infidelity also disappeared.