Spontaneous Ejaculation Due to Duloxetine: A Case Report

ABSTRACT Ejaculation is controlled by both the sympathetic and parasympathetic system and consists of an emission and expulsion phase. Ejaculation latency time is regulated by the sympathetic system. Hypothetically, by reducing ejaculatory latency time, spontaneous ejaculation can occur. Extending the duration of ejaculation is a well-known side effect of antidepressants, especially selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors and noradrenergic reuptake inhibitors. Adrenergic drugs are sometimes used as treatment for delayed ejaculation. A spontaneous ejaculation due to the use of these drugs has rarely been reported. Although most reports of spontaneous ejaculations are related to the use of venlafaxine and reboxetine, this study is based on a case of the side effect of duloxetine.

Pathological Gambling Due to Aripiprazole: Two Cases

ABSTRACT Aripiprazole is an atypical antipsychotic agent which has a partial agonistic effect on dopamine D2 and D3 receptors. It is effective in the treatment of schizophrenia and bipolar disorder. Owing to its partial agonistic effect, hyperactivity of dopamine may occur in the mesolimbic pathway. In the literature, there are few case reports about pathological gambling due to aripiprazole. In this article, there are two case reports of patients who showed pathological gambling behaviour and alcohol abuse and who were under treatment with aripiprazole. The patient had a history of gambling in the past. With the use of aripiprazole, pathological gambling behaviour occurred quickly and with discontinuation of aripiprazole it ended completely. Aripiprazole causes pathological gambling by forming a hyperdopaminergic condition in the mesolimbic dopaminergic pathway. Aripiprazole should be recommended cautiously and carefully to patients who are impulsive and have a history of alcohol/substance abuse.