Most people diagnosed with schizophrenia have the same interest in sex as the general population, but experience higher levels of sexual dysfunction in large part due to antipsychotic medications, according to a review of the literature published in Schizophrenia Bulletin. The researchers found some antipsychotics to be worse than others, and that clinicians rarely discuss sexual issues with patients.
“Although patients consider sexual problems to be highly relevant, patients and clinicians (do) not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment,” wrote the team of researchers from University Medical Center Groningen in The Netherlands. They noted that, “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,” they wrote. “Postsynaptic dopamine antagonism, prolactin elevation, and α1-receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction.”
The researchers found that “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.”
Boer, Marrit K. de, Stynke Castelein, Durk Wiersma, Robert A. Schoevers, and Henderikus Knegtering. “The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings.” Schizophrenia Bulletin 41, no. 3 (May 1, 2015): 674–86. doi:10.1093/schbul/sbv001. (Abstract)
