Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review

J Sex Marital Ther. 2012;38(3):281-301. doi: 10.1080/0092623X.2011.606883.

Abstract

There is limited evidence for the management of sexual dysfunction and/or hyperprolactinemia resulting from use of antipsychotics in patients with schizophrenia and spectrum. The aim of this study was to review and describe the strategies for the treatment of antipsychotic-induced sexual dysfunctions and/or hyperprolactinemia. The research was carried out through Medline/PubMed, Cochrane, Lilacs, Embase, and PsycINFO, and it included open labels or randomized clinical trials. The authors found 31 studies: 25 open-label noncontrolled studies and 6 randomized controlled clinical trials. The randomized, double-blind controlled studies that were conducted with adjunctive treatment that showed improvement of sexual dysfunction and/or decrease of prolactin levels were sildenafil and aripiprazole. The medication selegiline and cyproheptadine did not improve sexual function. The switch to quetiapine was demonstrated in 2 randomized controlled studies: 1 showed improvement in the primary outcome and the other did not. This reviewed data have suggested that further well-designed randomized controlled trials are needed to provide evidence for the effects of different strategies to manage sexual dysfunction and/or hyperprolactinaemia resulting from antipsychotics. These trials are necessary in order to have a better compliance and reduce the distress among patients with schizophrenia.

Publication types

  • Review

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Aripiprazole
  • Drug Substitution
  • Drug Therapy, Combination
  • Erectile Dysfunction / chemically induced
  • Erectile Dysfunction / drug therapy
  • Erectile Dysfunction / prevention & control
  • Female
  • Humans
  • Hyperprolactinemia / chemically induced
  • Hyperprolactinemia / prevention & control*
  • Male
  • Piperazines / administration & dosage
  • Piperazines / therapeutic use
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / psychology
  • Purines / administration & dosage
  • Quinolones / therapeutic use
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology
  • Sexual Dysfunction, Physiological / chemically induced
  • Sexual Dysfunction, Physiological / drug therapy
  • Sexual Dysfunction, Physiological / prevention & control*
  • Sildenafil Citrate
  • Sulfones / administration & dosage
  • Vasodilator Agents / administration & dosage

Substances

  • Antipsychotic Agents
  • Piperazines
  • Purines
  • Quinolones
  • Sulfones
  • Vasodilator Agents
  • Aripiprazole
  • Sildenafil Citrate