Sexually Inappropriate Behavior in Dementia

Q: 72 year old male with senile dementia is admitted in ICU with community-acquired pneumonia. While recovering from pneumonia, he continues to display episodes of agitation and sexually inappropriate behavior. Which of the following gastro-intestinal (GI) drug is found to be effective in Sexually Inappropriate Behavior in Dementia?

A) Cimetidine 
B) Bismuth subsalicylate 
C) Omeprazole 
D) Metoclopramide


Answer: A

Cimetidine is an H2 receptor antagonist but also carries anti-androgen effects via blocking the androgen receptor in the pituitary or the hypothalamus. It reduces both arousal and orgasm.

#psychiatry
#neurology


References

1. Knigge U, Dejgaard A, Wollesen F, Ingerslev O, Bennett P, Christiansen PM. The acute and long term effect of the H2- receptor antagonist cimetidine and ranitidine on the pituitary gonadal axis in men. Clin Endocrinol (Oxf). 1983;18(3):307-313.

2. Anand Beri, Alan Smith. Cimetidine Treatment of Sexually Inappropriate Behavior in Dementia: A Case Report and Literature Review. Annals of Long-Term Care: Clinical Care and Aging. 2015;23(6):39-42.