Methylphenidate for the treatment of erectile dysfunction induced by long acting injectable paliperidone palmitate: a case report

Erectile dysfunction is one of the common sexual adverse effects encountered in male patients treated with antipsychotics. It is associated with prolactin secretion secondary to dopamine antagonism by the antipsychotics. Methylphenidate is a psychostimulant that inhibits the reuptake of dopamine. In this case, we report a 42 year old schizophrenic male, who developed erectile dysfunction after administration of a long acting injectable antipsychotic, namely paliperidone palmitate. The erectile dysfunction did not respond to sildenafil but recovered with the treatment of methylphenidate 10mg. The current finding suggests that clinicians should be aware of the possible emergence of erectile dysfunction among patients on long acting injectable antipsychotics. Methylphenidate may be an alternative treatment option for erectile dysfunction induced by antipsychotics