Sexual dysfunction is very common among patients with schizophrenia. Sertindole is a non-sedating atypical antipsychotic drug with a low incidence of extra pyramidal side-effects. Male patients treated with sertindole often complain of decreased ejaculatory volume. This might be due to the α1 noradrenergic antagonist properties of sertindole. Whether the decreased ejaculatory volume is due to a retrograde ejaculation or due to the fact that the vas deferens is not contracted is unknown. Decreased ejaculatory volume or dry orgasm can be very intimidating for patients with schizophrenia because it might lead to feelings of not being a male or in worst case delusions about disappearing of the semen.

We investigated whether pseudoephedrine (brand name SUDAFED) can reverse the decreased ejaculatory volume induced by sertindole. Pseudoephedrine is an over-the-counter medication used for nasal congestion. Pseudoephedrine is a sympatomimetic amine with α1 agonist properties and is sometimes used for retrograde ejaculation caused by α1 blocking drugs used for benign prostatic hyperplasia. Patients were asked about quality of orgasm, changes in ejaculation volumen and other sexual problems during treatment with sertindole.