Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach
Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/2/308 |
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| author | Angel L. Montejo Rubén de Alarcón Nieves Prieto José Mª Acosta Bárbara Buch Laura Montejo |
| author_facet | Angel L. Montejo Rubén de Alarcón Nieves Prieto José Mª Acosta Bárbara Buch Laura Montejo |
| author_sort | Angel L. Montejo |
| collection | DOAJ |
| description | Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and their disenchantment with TESD can lead to important patient distress and treatment drop-out. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antipsychotic with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: prescribing either aripiprazole or another dopaminergic agonist as a first option antipsychotic or switching to it whenever possible. Whenever this is not possible, adjunctive treatment with aripiprazole seems to also be beneficial for reducing TESD. Some antipsychotics, like olanzapine, quetiapine, or ziprasidone, have less impact on sexual function than others, so they are an optimal second choice. Finally, a variety of useful strategies (such as the addition of sildenafil) are also described where the previous ones cannot be applied, although they may not yield as optimal results. |
| first_indexed | 2024-03-09T04:38:42Z |
| format | Article |
| id | doaj.art-103687f1d49048bbb852d5f377180000 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:38:42Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-103687f1d49048bbb852d5f3771800002023-12-03T13:23:53ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-0110230810.3390/jcm10020308Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical ApproachAngel L. Montejo0Rubén de Alarcón1Nieves Prieto2José Mª Acosta3Bárbara Buch4Laura Montejo5Psychiatry Service, Clinical Hospital of the University of Salamanca, 37007 Salamanca, SpainPsychiatry Service, Infanta Elena Hospital, Juan Ramon Jiménez Hospital, Ronda Exterior Norte S/N, 21080 Huelva, SpainPsychiatry Service, Clinical Hospital of the University of Salamanca, 37007 Salamanca, SpainInstitute of Biomedical Research of Salamanca (IBSAL), Paseo San Vicente SN, 37007 Salamanca, SpainInstitute of Biomedical Research of Salamanca (IBSAL), Paseo San Vicente SN, 37007 Salamanca, SpainBarcelona Bipolar and Depressive Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Hospital Clinic of Barcelona, 08401 Catalonia, SpainAntipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and their disenchantment with TESD can lead to important patient distress and treatment drop-out. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antipsychotic with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: prescribing either aripiprazole or another dopaminergic agonist as a first option antipsychotic or switching to it whenever possible. Whenever this is not possible, adjunctive treatment with aripiprazole seems to also be beneficial for reducing TESD. Some antipsychotics, like olanzapine, quetiapine, or ziprasidone, have less impact on sexual function than others, so they are an optimal second choice. Finally, a variety of useful strategies (such as the addition of sildenafil) are also described where the previous ones cannot be applied, although they may not yield as optimal results.https://www.mdpi.com/2077-0383/10/2/308antipsychoticsexual dysfunctionerectile dysfunctionanorgasmiaorgasm retardationTESD |
| spellingShingle | Angel L. Montejo Rubén de Alarcón Nieves Prieto José Mª Acosta Bárbara Buch Laura Montejo Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach Journal of Clinical Medicine antipsychotic sexual dysfunction erectile dysfunction anorgasmia orgasm retardation TESD |
| title | Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach |
| title_full | Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach |
| title_fullStr | Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach |
| title_full_unstemmed | Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach |
| title_short | Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach |
| title_sort | management strategies for antipsychotic related sexual dysfunction a clinical approach |
| topic | antipsychotic sexual dysfunction erectile dysfunction anorgasmia orgasm retardation TESD |
| url | https://www.mdpi.com/2077-0383/10/2/308 |
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