open access

Vol 3, No 1 (2006)
Review paper
Published online: 2006-03-23
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Biological mechanisms of antipsychotics adverse reactions in the field of sexual dysfunctions in schizophrenia

Wiesław Jerzy Cubała
Psychiatria 2006;3(1):15-21.

open access

Vol 3, No 1 (2006)
Prace poglądowe - nadesłane
Published online: 2006-03-23

Abstract

A number of patients with schizophrenia suffer from drug-related sexual and endocrine problems. Questionnaire studies suggest that 40-60% of the patients report sexual dysfunctions. Sexual dysfunction in patients with schizophrenia seems to be associated with the disease itself, psychosocial factors, medical health, as well as to the use of antypsychotics. Many of the conventional or typical antipsychotics have been associated with sexual dysfunction, such as decreased libido, erectile dysfunction, anorgasmia, delayed or retrograde ejaculation, oligomenorrhoea, and amenorrhoea. The contemporary literature hardly gives any information on systematic studies on the frequency and quality of sexual functioning in patients with schizophrenia. The limited information available suggests that some antipsychotics often induce sexual side effects and comparative studies are almost completely absent. The underlying mechanisms of sexual side effects induced by antipsychotics are only partly known. Several mechanisms contribute to the effects of antipsychotics on sexual functioning. Dopamine seems to be involved in almost all aspects of sexual behaviour and antipsychotics induced dopamine blockade playing a role in the impairment of all stages of sexual performance. The prolactin elevation associated with dopamine blockade interferes with erection as well as with other aspects of sexual performance in a dose dependent manner. Also some antipsychotics induce noradrenergic blockade, which is associated with disturbances in ejaculation and possibly lubrication. In addition serotonergic, histaminergic and hormonal effects contribute to the actual sexual performance. The aim of this paper is to depict the mechanisms underlying the sexual dysfunction associated with antipsychotic treatment.

Abstract

A number of patients with schizophrenia suffer from drug-related sexual and endocrine problems. Questionnaire studies suggest that 40-60% of the patients report sexual dysfunctions. Sexual dysfunction in patients with schizophrenia seems to be associated with the disease itself, psychosocial factors, medical health, as well as to the use of antypsychotics. Many of the conventional or typical antipsychotics have been associated with sexual dysfunction, such as decreased libido, erectile dysfunction, anorgasmia, delayed or retrograde ejaculation, oligomenorrhoea, and amenorrhoea. The contemporary literature hardly gives any information on systematic studies on the frequency and quality of sexual functioning in patients with schizophrenia. The limited information available suggests that some antipsychotics often induce sexual side effects and comparative studies are almost completely absent. The underlying mechanisms of sexual side effects induced by antipsychotics are only partly known. Several mechanisms contribute to the effects of antipsychotics on sexual functioning. Dopamine seems to be involved in almost all aspects of sexual behaviour and antipsychotics induced dopamine blockade playing a role in the impairment of all stages of sexual performance. The prolactin elevation associated with dopamine blockade interferes with erection as well as with other aspects of sexual performance in a dose dependent manner. Also some antipsychotics induce noradrenergic blockade, which is associated with disturbances in ejaculation and possibly lubrication. In addition serotonergic, histaminergic and hormonal effects contribute to the actual sexual performance. The aim of this paper is to depict the mechanisms underlying the sexual dysfunction associated with antipsychotic treatment.
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Keywords

antipsychotic drugs; sexual dysfunction; schizophrenia

About this article
Title

Biological mechanisms of antipsychotics adverse reactions in the field of sexual dysfunctions in schizophrenia

Journal

Psychiatria (Psychiatry)

Issue

Vol 3, No 1 (2006)

Article type

Review paper

Pages

15-21

Published online

2006-03-23

Bibliographic record

Psychiatria 2006;3(1):15-21.

Keywords

antipsychotic drugs
sexual dysfunction
schizophrenia

Authors

Wiesław Jerzy Cubała

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