Sexual Dysfunction in Psychiatric Inpatients The Role of Antipsychotic Medication

Westheide, Jens; Cohen, Sarah D.; Bender, Sara; Cooper‐Mahkorn, Déirdre; Erfurth, Andreas; Gastpar, Markus; Tj, Huber; Maier, W.; Murafi, A; Rothermund, M; Signerski, J; Sträter, Birgitta; Teusch, Ludwig; Weig, Wolfgang; Welling, A; Ku, Kühn

doi:10.1055/s-2007-981480

Cited by 26 publications

(21 citation statements)

References 20 publications

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“…Lower frequency rates are found using the same methods in nonmedicated psychotic patients [134]. Highest rates of dysfunction have been associated with thioridazine where the most common complaints are ED and retrograde ejaculation [135–137].…”

Section: Sexual Dysfunction In Psychiatric Diseasementioning

confidence: 88%

Sexual Function in Chronic Illness

Basson

Rees

Wang

et al. 2010

The Journal of Sexual Medicine

195

136

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Introduction Direct and indirect effects of chronic disease on sexual health are frequent and complex, but guidelines for their optimal management are lacking. With improved surgical and medical treatment of the underlying disease, the numbers of men and women needing assessment and management of associated sexual dysfunction are increasing. Aim To provide recommendations/guidelines for the clinical management of sexual dysfunction within the context of chronic illness. Methods An international consultation in collaboration with the major sexual medicine associations assembled 186 multidisciplinary experts from 33 countries into 25 committees. Nine experts from four countries compiled the recommendations of sexual dysfunction in chronic illness and cancer with four focusing on neurological, renal, and psychiatric disease and lower urinary tract symptoms (LUTS). Searches were conducted using Medline, Embase, Lilacs, and Pubmed databases. Main Outcome Measures Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results Some conclusions concerning prevalence and pathophysiology of sexual dysfunction in the context of neurological disorders, end-stage renal failure, LUTS, and psychiatric disease were made. Optimal assessment of the multiple factors affecting sexuality when one or both partners are chronically ill is outlined. Evidence-based recommendations for management are presented. Comorbid depression is frequent and independently determines prevalence of sexual dysfunction in many conditions. Conclusions There is need for more research and scientific reporting on prevalence, pathophysiology, and optimal treatment of sexual dysfunction associated with chronic illness. Screening for and managing comorbid depression is strongly recommended.

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Section: Sexual Dysfunction In Psychiatric Diseasementioning

confidence: 88%

Sexual Function in Chronic Illness

Basson

Rees

Wang

et al. 2010

The Journal of Sexual Medicine

195

136

View full text Add to dashboard Cite

show abstract

“…Dose increases seem to result in better clinical outcomes while dose decreases (when decided by the psychiatrists based on clinical reasons), do not seem to aff ect the maintenance of the response. Psychiatrists may decide to decrease dose to avoid potential unwanted eff ects [7,23,32] while maintaining eff ectiveness. Changes in olanzapine dose were not associated with worsening EPS, TD, sexual problems, potential " hyperprolactinaemia " related symptoms or weight gain.…”

Section: Discussion ▼mentioning

confidence: 99%

Reasons and Outcomes of Olanzapine Dose Adjustments in the Outpatient Treatment of Schizophrenia

Suarez¹,

Haro²,

Novick³

et al. 2009

Pharmacopsychiatry

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“…Prolactin in turn has an inhibiting effect on the tuberoinfundibular dopaminergic neurons, thereby completing the feedback mechanism between dopamine and prolactin. 66 Antipsychotic-induced hyperprolactinemia has been associated with a number of side effects including galactorrhea, menstrual disturbances, amenorrhea, and sexual dysfunction, 5,[67][68][69][70] although some studies only confirm this for subgroups of patients, 71,72 or do not find an association between prolactin levels and sexual dysfunction. 73 In contrast to risperidone and classical antipsychotics, clozapine, quetiapine, and olanzapine do not appear to cause sustained elevated levels of prolactin.…”

Section: Pharmacological Mechanisms In Antipsychotic-induced Sexual Dmentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

135

115

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A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.

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Sexual Dysfunction in Psychiatric Inpatients The Role of Antipsychotic Medication

Abstract: Sexual dysfunction frequently occurs in psychiatric inpatients treated with antipsychotics. Our findings only partly support the assumptions concerning a major role of prolactin-increasing neuroleptics for medication-induced sexual impairment.

Cited by 26 publications

References 20 publications

Sexual Function in Chronic Illness

Sexual Function in Chronic Illness

Reasons and Outcomes of Olanzapine Dose Adjustments in the Outpatient Treatment of Schizophrenia

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

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