Olanzapine Induced Hypersexuality

Hypersexuality is a recognized symptom of psychiatric disorders, namely mood and psychotic disorders. It has been known to accompany other personality changes in frontal lobe dementia. Dopaminergic therapy used to alleviate manifestations of Parkinson’s disease may cause hypersexuality. Similarly, albeit less commonly, a paradoxical reaction to antipsychotic therapy could also result in hypersexualized behaviours. Dopamine receptor therapy has also been reported to worsen hypersexuality. It has also been observed to occur with impulse control disorders such as excessive eating, gambling, compulsive shopping and hypersexuality. Dopaminergic pathways play a vital role in the brain’s reward mechanism and pathological interference could result in addictive behaviours. Dopaminergic neurotransmission has been associated with drug abuse. These commonalities between impulse control behaviours and drug addictions cannot be overlooked. Hypersexuality resulting from second generation antipsychotic (SGA) treatment is poorly understood. In recent years there have been case reports of Risperidone induced hypersexuality. Aripiprazole is slowly gaining recognition for its partial dopamine agonism causing hypersexuality. However, only a handful of cases with Olanzapine induced hypersexuality have been reported globally. We report hypersexuality in a young man with Paranoid Schizophrenia shortly after starting Olanzapine, with evidence possibly linking Olanzapine therapy to hypersexualized behaviours.

Keywords: Hypersexuality; second generation antipsychotic treatment; olanzapine; paranoid schizophrenia