Significant improvement of risperidone-induced retrograde ejaculation on drug holidays: a case report

ABSTRACT Risperidone, which is one of the most commonly prescribed second-generation antipsychotics can cause several sexual adverse effects. To date, research on the sexual side effects of risperidone has been mostly restricted to symptoms of decreased libido, erectile dysfunction and delayed ejaculation and far too little attention has been paid to risperidone associated retrograde ejaculation. What is not clear is that whether this side effect appears in a dose-dependent manner and whether structured treatment interruptions/drug holidays can diminish sexual adverse effects without a reduction in treatment efficacy. Another question is whether concurrent use of opiates and risperidone can increase the risk of retrograde ejaculation due to their anticholinergic and adrenergic blocking properties. Here we describe a case of a 30-year-old male with schizophrenia and opium dependence who developed risperidone-induced retrograde ejaculation; however, the ejaculatory dysfunction improved significantly on drug holidays. This is the first report on the use of structured treatment interruptions in the management of risperidone-induced retrograde ejaculation