World J Mens Health.  2012 Dec;30(3):153-159.

Antipsychotic-Induced Sexual Dysfunction and Its Management

Affiliations
  • 1Department of Urology, National Police Hospital, Seoul, Korea. bonanza96@hanmail.net

Abstract

Sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect, resulting in a negative effect on treatment compliance. It is known that hyperprolactinemia is a major cause of sexual dysfunction. Based on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics, while olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole are classed as prolactin-sparing drugs. Risperidone and the other typical antipsychotics are associated with a high rate of sexual dysfunction as compared to olanzapine, clozapine, quetiapine, and aripiprazole. With regard to treatment in patients suffering from sexual dysfunction, sildenafil was associated with significantly more erections sufficient for penetration as compared to a placebo. Subsequent studies are needed in order to provide physicians with a better understanding of this problem, thereby leading toward efficacious and safe solutions.

Keyword

Sexual dysfunction; Antipsychotic agents; Management

MeSH Terms

Antipsychotic Agents
Benzodiazepines
Clozapine
Compliance
Dibenzothiazepines
Haloperidol
Humans
Hyperprolactinemia
Piperazines
Purines
Quinolones
Receptors, Dopamine D2
Risperidone
Stress, Psychological
Sulfones
Sulpiride
Thiazoles
Aripiprazole
Quetiapine Fumarate
Sildenafil Citrate
Antipsychotic Agents
Benzodiazepines
Clozapine
Dibenzothiazepines
Haloperidol
Piperazines
Purines
Quinolones
Receptors, Dopamine D2
Risperidone
Sulfones
Sulpiride
Thiazoles

Reference

1. Finn SE, Bailey JM, Schultz RT, Faber R. Subjective utility ratings of neuroleptics in treating schizophrenia. Psychol Med. 1990; 20:843–848. PMID: 1980954.
Article
2. Lambert M, Conus P, Eide P, Mass R, Karow A, Moritz S, et al. Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry. 2004; 19:415–422. PMID: 15504648.
Article
3. Olfson M, Uttaro T, Carson WH, Tafesse E. Male sexual dysfunction and quality of life in schizophrenia. J Clin Psychiatry. 2005; 66:331–338. PMID: 15766299.
Article
4. Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs. 2004; 64:2291–2314. PMID: 15456328.
5. Knegtering H, van der Moolen AE, Castelein S, Kluiter H, van den Bosch RJ. What are the effects of antipsychotics on sexual dysfunctions and endocrine functioning? Psychoneuroendocrinology. 2003; 28(Suppl 2):109–123. PMID: 12650685.
Article
6. Kelly DL, Conley RR. Sexuality and schizophrenia: a review. Schizophr Bull. 2004; 30:767–779. PMID: 15954189.
Article
7. Smith SM, O'Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002; 181:49–55. PMID: 12091263.
Article
8. Serretti A, Chiesa A. A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics. Int Clin Psychopharmacol. 2011; 26:130–140. PMID: 21191308.
Article
9. Knegtering H, Boks M, Blijd C, Castelein S, van den Bosch RJ, Wiersma D. A randomized open-label comparison of the impact of olanzapine versus risperidone on sexual functioning. J Sex Marital Ther. 2006; 32:315–326. PMID: 16709552.
Article
10. Knegtering R, Castelein S, Bous H, Van Der Linde J, Bruggeman R, Kluiter H, et al. A randomized open-label study of the impact of quetiapine versus risperidone on sexual functioning. J Clin Psychopharmacol. 2004; 24:56–61. PMID: 14709948.
Article
11. Knegtering H, van den Bosch R, Castelein S, Bruggeman R, Sytema S, van Os J. Are sexual side effects of prolactin-raising antipsychotics reducible to serum prolactin? Psychoneuroendocrinology. 2008; 33:711–717. PMID: 18395353.
Article
12. Kinon BJ, Ahl J, Liu-Seifert H, Maguire GA. Improvement in hyperprolactinemia and reproductive comorbidities in patients with schizophrenia switched from conventional antipsychotics or risperidone to olanzapine. Psychoneuroendocrinology. 2006; 31:577–588. PMID: 16488084.
Article
13. Kelly DL, Conley RR. A randomized double-blind 12-week study of quetiapine, risperidone or fluphenazine on sexual functioning in people with schizophrenia. Psychoneuroendocrinology. 2006; 31:340–346. PMID: 16198059.
Article
14. Dossenbach M, Dyachkova Y, Pirildar S, Anders M, Khalil A, Araszkiewicz A, et al. Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. Eur Psychiatry. 2006; 21:251–258. PMID: 16530390.
Article
15. Bobes J, Garc A-Portilla MP, Rejas J, Hern Ndez G, Garcia-Garcia M, Rico-Villademoros F, et al. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. J Sex Marital Ther. 2003; 29:125–147. PMID: 12623765.
Article
16. Spollen JJ 3rd, Wooten RG, Cargile C, Bartztokis G. Prolactin levels and erectile function in patients treated with risperidone. J Clin Psychopharmacol. 2004; 24:161–166. PMID: 15206663.
Article
17. Eberhard J, Lindström E, Holstad M, Levander S. Prolactin level during 5 years of risperidone treatment in patients with psychotic disorders. Acta Psychiatr Scand. 2007; 115:268–276. PMID: 17355517.
18. Aizenberg D, Modai I, Landa A, Gil-Ad I, Weizman A. Comparison of sexual dysfunction in male schizophrenic patients maintained on treatment with classical antipsychotics versus clozapine. J Clin Psychiatry. 2001; 62:541–544. PMID: 11488365.
Article
19. Turrone P, Kapur S, Seeman MV, Flint AJ. Elevation of prolactin levels by atypical antipsychotics. Am J Psychiatry. 2002; 159:133–135. PMID: 11772702.
Article
20. Mullen B, Brar JS, Vagnucci AH, Ganguli R. Frequency of sexual dysfunctions in patients with schizophrenia on haloperidol, clozapine or risperidone. Schizophr Res. 2001; 48:155–158. PMID: 11345946.
Article
21. Cutler AJ. Sexual dysfunction and antipsychotic treatment. Psychoneuroendocrinology. 2003; 28(Suppl 1):69–82. PMID: 12504073.
Article
22. Crawford AM, Beasley CM Jr, Tollefson GD. The acute and long-term effect of olanzapine compared with placebo and haloperidol on serum prolactin concentrations. Schizophr Res. 1997; 26:41–54. PMID: 9376336.
Article
23. Tran PV, Hamilton SH, Kuntz AJ, Potvin JH, Andersen SW, Beasley C Jr, et al. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol. 1997; 17:407–418. PMID: 9315992.
Article
24. Bitter I, Basson BR, Dossenbach MR. Antipsychotic treatment and sexual functioning in first-time neuroleptic-treated schizophrenic patients. Int Clin Psychopharmacol. 2005; 20:19–21. PMID: 15602111.
Article
25. Borison RL, Arvanitis LA, Miller BG. U.S. Seroquel Study Group. ICI 204,636, an atypical antipsychotic: efficacy and safety in a multicenter, placebo-controlled trial in patients with schizophrenia. J Clin Psychopharmacol. 1996; 16:158–169. PMID: 8690831.
26. Arvanitis LA, Miller BG. The Seroquel Trial 13 Study Group. Multiple fixed doses of "Seroquel" (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. Biol Psychiatry. 1997; 42:233–246. PMID: 9270900.
Article
27. Small JG, Hirsch SR, Arvanitis LA, Miller BG, Link CG. Seroquel Study Group. Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Arch Gen Psychiatry. 1997; 54:549–557. PMID: 9193196.
28. King DJ, Link CG, Kowalcyk B. A comparison of bd and tid dose regimens of quetiapine (Seroquel) in the treatment of schizophrenia. Psychopharmacology (Berl). 1998; 137:139–146. PMID: 9630000.
Article
29. Dossenbach M, Hodge A, Anders M, Molnár B, Peciukaitiene D, Krupka-Matuszczyk I, et al. Prevalence of sexual dysfunction in patients with schizophrenia: international variation and underestimation. Int J Neuropsychopharmacol. 2005; 8:195–201. PMID: 15631645.
Article
30. Casey DE, Carson WH, Saha AR, Liebeskind A, Ali MW, Jody D, et al. Aripiprazole Study Group. Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study. Psychopharmacology (Berl). 2003; 166:391–399. PMID: 12610718.
Article
31. Kasper S, Lerman MN, McQuade RD, Saha A, Carson WH, Ali M, et al. Efficacy and safety of aripiprazole vs. haloperidol for long-term maintenance treatment following acute relapse of schizophrenia. Int J Neuropsychopharmacol. 2003; 6:325–337. PMID: 14609439.
Article
32. Lee BH, Kim YK, Park SH. Using aripiprazole to resolve antipsychotic-induced symptomatic hyperprolactinemia: a pilot study. Prog Neuropsychopharmacol Biol Psychiatry. 2006; 30:714–717. PMID: 16571367.
Article
33. Marder SR, McQuade RD, Stock E, Kaplita S, Marcus R, Safferman AZ, et al. Aripiprazole in the treatment of schizophrenia: safety and tolerability in short-term, placebo-controlled trials. Schizophr Res. 2003; 61:123–136. PMID: 12729864.
Article
34. McQuade RD, Stock E, Marcus R, Jody D, Gharbia NA, Vanveggel S, et al. A comparison of weight change during treatment with olanzapine or aripiprazole: results from a randomized, double-blind study. J Clin Psychiatry. 2004; 65(Suppl 18):47–56. PMID: 15600384.
35. Pigott TA, Carson WH, Saha AR, Torbeyns AF, Stock EG, Ingenito GG. Aripiprazole Study Group. Aripiprazole for the prevention of relapse in stabilized patients with chronic schizophrenia: a placebo-controlled 26-week study. J Clin Psychiatry. 2003; 64:1048–1056. PMID: 14628980.
36. Potkin SG, Saha AR, Kujawa MJ, Carson WH, Ali M, Stock E, et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2003; 60:681–690. PMID: 12860772.
Article
37. Baggaley M. Sexual dysfunction in schizophrenia: focus on recent evidence. Hum Psychopharmacol. 2008; 23:201–209. PMID: 18338766.
Article
38. Hanssens L, L'Italien G, Loze JY, Marcus RN, Pans M, Kerselaers W. The effect of antipsychotic medication on sexual function and serum prolactin levels in community-treated schizophrenic patients: results from the Schizophrenia Trial of Aripiprazole (STAR) study (NCT00237913). BMC Psychiatry. 2008; 8:95. PMID: 19102734.
Article
39. Mir A, Shivakumar K, Williamson RJ, McAllister V, O'Keane V, Aitchison KJ. Change in sexual dysfunction with aripiprazole: a switching or add-on study. J Psychopharmacol. 2008; 22:244–253. PMID: 18308789.
Article
40. Berner MM, Hagen M, Kriston L. Management of sexual dysfunction due to antipsychotic drug therapy. Cochrane Database Syst Rev. 2007; (1):CD003546. PMID: 17253492.
Article
41. Gopalakrishnan R, Jacob KS, Kuruvilla A, Vasantharaj B, John JK. Sildenafil in the treatment of antipsychotic-induced erectile dysfunction: a randomized, double-blind, placebo-controlled, flexible-dose, two-way crossover trial. Am J Psychiatry. 2006; 163:494–499. PMID: 16513872.
Article
42. Kodesh A, Weizman A, Aizenberg D, Hermesh H, Gelkopf M, Zemishlany Z. Selegiline in the treatment of sexual dysfunction in schizophrenic patients maintained on neuroleptics: a pilot study. Clin Neuropharmacol. 2003; 26:193–195. PMID: 12897639.
Article
43. Costa AM, Lima MS, Mari Jde J. A systematic review on clinical management of antipsychotic-induced sexual dysfunction in schizophrenia. Sao Paulo Med J. 2006; 124:291–297. PMID: 17262163.
Article
44. Dossenbach M, Erol A, el Mahfoud Kessaci M, Shaheen MO, Sunbol MM, Boland J, et al. IC-SOHO Study Group. Effectiveness of antipsychotic treatments for schizophrenia: interim 6-month analysis from a prospective observational study (IC-SOHO) comparing olanzapine, quetiapine, risperidone, and haloperidol. J Clin Psychiatry. 2004; 65:312–321. PMID: 15096069.
Full Text Links
  • WJMH
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr