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Catello Orazzo, Francesca Bortolotti e Palmiero Monteleone


Istituto di Psichiatria,

Seconda Università di Napoli















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91. WASS JOH, THORNER MO, MORRIS DV, et al. Long term treatment of acromegalia with bromocriptine. Brit Med J 1977; I (?): 875.

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Possibile ruolo dei neurotrasmettitori






  • inibizione della risposta eiaculatoria

  • inibizione della risposta sessuale

inibizione dell'attività sessuale (osservazioni cliniche: mancano dati sperimentali attendibili)


  • abbassamento della soglia del riflesso erettile ed eiaculatorio

  • aumento della reattività sessuale

miglioramento della reattività sessuale o nessuna interferenza con la risposta sessuale



- induzione dell'erezione

  • inibizione dell'erezione

  • facilitazione dell'eiaculazione


- inibizione dell'erezione in seguito a stimolazione elettrica dei nervi parasimpatici sacrali

  • modulazione della risposta sessuale agli altri neurotrasmettitori

possibile facilitazione dell'orgasmo (la microinfusione nella regione settale di donna epilettica ha provocato orgasmi ripetuti)







Psosibili interventi farmacologici




Riduzione della posologia

Ripresa della sintomatologia depressiva


Trattamento con neostigmina

Mioclonie, sudorazione, scialorrea, pollachiuria, nausea, vomito, diarrea

Rimedio valido soprattutto per i disturbi dell'eiaculazione (7,5-15 mg per os prima del rapporto sessuale)

Trattamento con yoimbina (da 4 a 7,5 mg per os, prima del rapporto sessuale)

Ansia, aumento della pressione arteriosa, irritabilità, tremore, pollachiuria, nausea, vomito

  • Non è in commercio in Italia

  • Rimedio valido soprattutto in caso di ridotta libido o di inibizione dell'orgasmo da farmaci serotoninergici

Sostituzione del farmaco con bupropione

Irritabilità, insonnia, cefalea, perdita di peso

- Non è in commercio in Italia

Sostituzione con nefazodone

Xerostomia, nausea, cefalea


Sostituzione con trazodone

Rischio di priapismo

  • Rimedio valido soprattutto nelle disfunzioni erettili

Sostituzione con mirtazepina

Xerostomia, stipsi, sonnolenza, sedazione

  • Scarsa documentazione

  • Rimedio valido soprattutto nelle disfunzioni erettili e nei disturbi dell'orgasmo

Trattamento con ciproeptadina

Possibilità di antagonizzare l'effetto antidepressivo secondario all'uso di farmaci serotoninergici

Rimedio valido soprattutto nei disturbi dell'orgasmo (4-8 mg per os, 1 o 2 ore prima del rapporto sessuale)



Disturbi della funzionalità sessuale nel corso di trattamenti antipsicotici





Disturbi dell'orgasmo



Irregolarità mestruali

Riduzione del volume dell'eiaculato

Disturbi dell'orgasmo

Riduzione della libido

Riduzione della libido







Possibili interventi terapeutici per le DSSP da antipsicotici



Possibili conseguenze

Sospensione del trattamento o riduzione della posologia

Ricomparsa dei sintomi psicotici

Sostituire un farmaco ad alta azione adrenolitica con uno a bassa azione


Sospensione dell'anticolinergico o sostituzione con amantadina

Ricomparsa delle manifestazioni extrapiramidali

Trattamento con bromocriptina

Ricomparsa dei sintomi psicotici



Trattamento dei DSSP da sali di litio




Riduzione della posologia

Ricomparsa del disturbo dell'umore

Controllare la litiemia prima della riduzione posologica

Sostituzione del litio con altri stabilizzatori dell'umore

Ricomparsa del disturbo dell'umore


Passare da un intervento preventivo ad un intervento curativo

Aumento del numero degli episodi patologici


Prolungare il trattamento con i sali di litio

Scarsa compliance

In genere dopo 2-3 mesi di trattamento con i sali di litio i sintomi sessuali regrediscono

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