Estratégia de manejo para a disfunção sexual induzida por antipsicóticos: descrição de um relato de caso

Nunes, Luciana Vargas Alves; Dieckmann, Luiz Henrique Junqueira; Lacaz, Fernando Sargo; Bressan, Rodrigo A.; Mari, Jair de Jesus

doi:10.1590/s1516-44462008000300022

Cited by 3 publications

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References 5 publications

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“…There is a case report of a man suffering from schizophrenia who was successfully treated with sildenafil for 6 months . Another case report described the use of tadalafil in the treatment of erectile dysfunction in a married male schizophrenic outpatient with a good response .…”

Section: Introductionmentioning

confidence: 99%

Adjunctive Treatment with Lodenafil Carbonate for Erectile Dysfunction in Outpatients with Schizophrenia and Spectrum: A Randomized, Double-Blind, Crossover, Placebo-Controlled Trial

Nunes

Lacaz

Bressan

et al. 2013

The Journal of Sexual Medicine

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Introduction Evidence is accumulating to support the presence of erectile dysfunction in patients with schizophrenia. This dysregulation may be amenable to therapeutic intervention to improve adherence and quality of life of patients who suffer from schizophrenia and schizoaffective disorders. Aim We aimed to evaluate the use of adjunctive medication lodenafil for the treatment of erectile dysfunction in outpatients with schizophrenia and spectrum. Methods The design was a randomized, double-blind, crossover, placebo-controlled trial with lodenafil and it was carried at the Schizophrenia Outpatients Program. Main Outcome Measures The measures used to assess sexual dysfunction were Arizona Sexual Experiences Scale (ASEX) and International Index of Erectile Function (IIEF). The Positive and Negative Syndrome Scale (PANSS) and the Quality of Life Scale (QLS) were also used. The measures included the levels of prolactin, estradiol, luteinizing hormone, sex hormone-binding globulin, free testosterone, and total testosterone at baseline and end point. Lodenafil and placebo pills were used by the patients for 16 weeks. Results Fifty male outpatients fulfilled the criteria and 94% of the participants completed the study. Lodenafil and placebo produced improvement in ASEX, IIEF scale, PANSS, and QLS, and there was no statistical difference between lodenafil and placebo groups in all sexual domains in the results of PANSS and QLS and in the results of hormone levels. Conclusion These results indicate that both lodenafil and placebo were effective in the treatment of erectile dysfunction for schizophrenia. Placebo effect is very important in patients with schizophrenia and this study showed the importance of discussing sexuality and trying to treat these patients. Further studies designed to test treatments of erectile dysfunction in patients who suffer from schizophrenia are necessary.

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Section: Introductionmentioning

confidence: 99%

Adjunctive Treatment with Lodenafil Carbonate for Erectile Dysfunction in Outpatients with Schizophrenia and Spectrum: A Randomized, Double-Blind, Crossover, Placebo-Controlled Trial

Nunes

Lacaz

Bressan

et al. 2013

The Journal of Sexual Medicine

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Managing antipsychotic-related sexual dysfunction in patients with schizophrenia

Silva,

Rebelo,

Chendo

2023

Expert Review of Neurotherapeutics

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Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach

Montejo

Alarcón

Prieto

et al. 2021

JCM

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Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and their disenchantment with TESD can lead to important patient distress and treatment drop-out. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antipsychotic with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: prescribing either aripiprazole or another dopaminergic agonist as a first option antipsychotic or switching to it whenever possible. Whenever this is not possible, adjunctive treatment with aripiprazole seems to also be beneficial for reducing TESD. Some antipsychotics, like olanzapine, quetiapine, or ziprasidone, have less impact on sexual function than others, so they are an optimal second choice. Finally, a variety of useful strategies (such as the addition of sildenafil) are also described where the previous ones cannot be applied, although they may not yield as optimal results.

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Estratégia de manejo para a disfunção sexual induzida por antipsicóticos: descrição de um relato de caso

Cited by 3 publications

References 5 publications

Adjunctive Treatment with Lodenafil Carbonate for Erectile Dysfunction in Outpatients with Schizophrenia and Spectrum: A Randomized, Double-Blind, Crossover, Placebo-Controlled Trial

Adjunctive Treatment with Lodenafil Carbonate for Erectile Dysfunction in Outpatients with Schizophrenia and Spectrum: A Randomized, Double-Blind, Crossover, Placebo-Controlled Trial

Managing antipsychotic-related sexual dysfunction in patients with schizophrenia

Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach

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