Efficacy of transdermal rivastigmine for treatment hypersexuality in Alzheimer disease

Abstract

Objective: Hypersexuality in Alzheimer's disease (AD) has been rarely investigated. No randomized clinical trials regarding the treatment of hypersexuality in demented people have been conducted, but available data from isolated case reports suggest the efficacy of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, antiandrogens, and H2-receptor antagonists. Method: The patient was a 72-year-old man, who presented for a neuropsychological evaluation performed at the Elbistan State Hospital with a Mini-Mental State Examination (MMSE) value of 18/30. The presenting symptom was persistent sexual desire. Transdermal rivastigmine was started at a dose of 5 (9mg) once daily and the sexual desires terminated on the second week of the treatment. Unfortunately, hypersexuality occurred 1 month later. Rivastigmine patch 10 (18 mg) was prescribed again to reduce the hypersexuality, and this proved to be effective. Result: We present a case of a 72-year-old male patient with Alzheimer's disease with hypersexual behaviour as reported by his wife. Our patient exhibited significant improvement with rivastigmine. Conclusion: Hypersexuality, also referred to in the literature as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others. In this case we would like to emphasize that cholinesterase inhibitors can be effective in treatment of hypersexuality in Alzheimer's disease.