Sexual Function in Male Patients Treated with Antipsychotics

Overview

There has been an increasing interest in sexual side effects and changes in endocrine functions in schizophrenic patients treated with antipsychotics. Evaluation of sexual functions in schizophrenic patients is complicated among other things due to the fact that this serious illness in itself impairs social relations and induces problems in finding a mate. A drop in libido is regarded as one of the negative symptoms of schizophrenia, together with inability to find a mate and withdrawal from social life.

Antipsychotic treatment, especially treatment with atypical antipsychotics, improves these symptoms to the effect that the patients benefit from the therapy, have fewer psychotic symptoms and their sociability and capacity for maintaining relationships with their mates improve. On the other hand, due to the mechanism of action, antipsychotics may have a negative impact on the sexual functions.

From June 2003 through October 2004, 193 patients with the diagnosis of schizophrenic or schizoaffective disorder were treated in the male psychotic ward. No more than 64 of them enjoyed full sexual life. Thirty patients responded to questions regarding their sexual activity using the ASEX scale. They were 6 patients with the first episode of schizophrenia and 24 patients with further schizophrenic episodes. Sexual dysfunction as measured on the ASEX scale was identified in 14 patients while 16 patients had no sexual dysfunction. The most frequent incidence of sexual dysfunction was observed in risperidone therapy. The data showed that two thirds of patients with acute exacerbation of the schizophrenic disorder had no sexual activity. Nearly one half sexually active patients were found to suffer from sexual dysfunction, which was most frequently on risperidone therapy.

As the patients were those switching from in-patient to out-patient therapy, a potential merit of treatment with atypical antipsychotics associated with their social relations and relationships with their mates has been impossible to identify yet.

Key words:
schizophrenia, sexual dysfunction, antipsychotics.