Thursday, September 19, 2019

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.



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.

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