Priapism and <scp>Second‐Generation</scp> Antipsychotics: Disproportionality Analysis of a Spontaneous Reporting System Database in Japan

Misawa, Fuminari; Takeuchi, Hiroyoshi

doi:10.1111/pcn.13443

Cited by 2 publications

(1 citation statement)

References 9 publications

(21 reference statements)

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“…Research indicates that the anticholinergic and alpha-adrenergic effects of certain antipsychotics can impact sexual function, which may include the inhibition of motivation and reward, increased sedation, and reduced peripheral vasodilatation ( Knegtering et al, 2003 ; Haddad and Wieck, 2004 ). Specifically, the relationship between alpha-1 adrenergic receptor affinities of antipsychotics and the occurrence of priapism has been discussed in several previous studies ( Andersohn et al, 2010 ; Subeesh et al, 2019 ; Misawa and Takeuchi, 2022 ). It is also reported that the occurrence of erectile problems associated with APs may account for endothelial dysfunction, which is characterized by decreased nitric oxide production due to the inhibition of endothelial nitric oxide synthase ( Montes de Oca et al, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

The atypical antipsychotics and sexual dysfunction: a pharmacovigilance-pharmacodynamic study

Cheng,

Chen,

Zhao

et al. 2024

Front. Pharmacol.

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BackgroundAtypical antipsychotics (AAPs)-induced sexual dysfunction (SD) is a frequent issue in clinical practice, often underestimated by clinicians and not extensively researched. The current study aimed to quantify the strength of association between the use of different AAPs and SD using real-world data from the FDA Adverse Event Reporting System (FAERS), as well as investigate the receptor mechanisms that are involved.MethodsData from the FAERS database from the first quarter of 2004 to the third quarter of 2023 were queried through OpenVigil 2.1. Disproportionality analysis was estimated using the reporting odds ratio (ROR) and information component (IC) methods, and linear regression was used to investigate the relationship between ROR and receptor occupancy which was estimated using in vitro receptor binding profiles.ResultsOur analysis yielded 4839 reports that co-mentioned AAP and SD events, and the findings revealed statistical associations between 12 AAPs and SD. The highest signal value was identified for iloperidone reporting retrograde ejaculation with iloperidone (ROR = 832.09, ROR025 = 552.77; IC = 9.58, IC025 = 6.36), followed by compulsive sexual behavior with aripiprazole (ROR = 533.02, ROR025 = 435.90; IC = 7.30, IC025 = 5.97), and psychosexual disorder for aripiprazole (ROR = 145.80, ROR025 = 109.57; IC025 = 6.47, IC025 = 4.86). Different characteristics of the SD side effects in each AAPs were discovered after further data mining. Regression analysis revealed potential effects for receptor occupancy of D2, D3, and 5-HT1A receptors on ROR. However, no significant correlation persisted following sensitivity analyses.ConclusionThis is the first study to investigate the AAP-SD associations by using FAERS. In this study, we report for the first time a significant association between aripiprazole and SD based on real-world data. The study suggests that different AAPs have varying levels of association with SD, and the D2, D3, and 5-HT1A receptor occupancy may contribute to potential mechanisms. The findings of this study warrant further validation of more studies and clinical causality assessment.

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