RESUMEN
Inappropriate verbal and physical sexual behaviour is not common among individuals with dementia, but when it does occur, it can have profound consequences. We report a case of 79-year-old woman with dementia of the Alzheimer's type who complained of increased libido after an increased dose of donepezil, which was being used along with tianeptine. Donepezil withdrawal led to the resolution of increased libido, but when it was reintroduced, increased libido reappeared once again (Naranjo score: 7). Increased libido was not reported by the patient during the 6-year follow-up period after donepezil withdrawal. A potential mechanism of acetylcholinesterase inhibitor-induced increased libido and the current literature on hypersexuality as a side-effect of donepezil treatment are discussed.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Antidepresivos Tricíclicos/uso terapéutico , Inhibidores de la Colinesterasa/uso terapéutico , Indanos/uso terapéutico , Libido , Piperidinas/uso terapéutico , Tiazepinas/uso terapéutico , Donepezilo , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/inducido químicamente , Resultado del TratamientoAsunto(s)
Internacionalidad , Prevención Primaria/métodos , Psiquiatría , Prevención del Suicidio , Adulto , HumanosRESUMEN
OBJECTIVES: To establish possible differences in gender, age and urgency between patients with anxiety disorders, stress related disorders and somatoform disorders and patients with other psychiatric diagnoses. SUBJECTS AND METHODS: 2760 consecutive admissions in the Psychiatric Emergency Out-patient Clinic (PEOC) over the period 2004-2005 were included. Data about diagnosis (ICD-10), gender, age and urgency were gathered from medical documentation. Data were compared between two groups of patients according to diagnosis; the first group encompassed anxiety disorders, stress related disorders and somatoform disorders (F 40-F 48) and the second group gathered all other psychiatric diagnoses (others). RESULTS: One third (36%) of patients examined in PEOC suffered for anxiety disorders, stress related disorders and somatoform disorders. The most common diagnoses within this group were stress related disorders (F 43: 41.7%). Gender ratio was in favour of women in both groups. Significantly more women suffered for anxiety, stress-related and somatoform disorders (63.4% vs. 56.9%, p<0.005). Patients with anxiety, stress-related and somatoform disorders were significantly younger compared with others (40.4 years vs. 45.2 years, p<0.001), and they were significantly less urgent cases compared with others (46.7% vs. 65.3.3%, p<0.001). CONCLUSION: Anxiety disorders, stress related disorders and somatoform disorders are common in PEOC. The higher percentage of women among these patients is in accordance with data from the literature; lower age might be a consequence of earlier onset of the above mentioned disorders.