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Drug-Induced Sexual Dysfunction

  • Duane E. McWaine
  • Warren R. Procci
Review Article Adverse Drug Experience Review

Summary

A large body of data, as well as clinical experience, link prescribed medications and substances of abuse with sexual dysfunction. This review surveys the relevant literature and summarises key points relating various classes of medications and their possible sexual side effects.

Surprisingly, there were very few carefully designed, well organised, systematic studies of the effects of medication upon sexual performance. The preponderance of data is in the form of either case studies or collections of patient reports of side effects. As a result, there are great variations in the reported rates of sexual disturbances associated with the administration of a given medication. A further difficulty is the lack of precision in the use of terms which describe the various sexual disorders. A final problem is the almost total lack of data concerning both disordered and normal sexual functioning in females.

Keywords

Sexual Dysfunction Sexual Performance Methyldopa Priapism Sexual Response 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Abramowicz M. Clonidine (catapres) and other drugs causing sexual dysfunction. Medical Letter 19: 81–82, 1977Google Scholar
  2. Akhtar MJ. Sexual disorders in male alcoholics. In Madden et al. (Eds) Alcoholism and drug dependence, pp. 3–13, Plenum Press, New York, 1977CrossRefGoogle Scholar
  3. Alexander WD, Evans JL. Side effects of methyldopa. British Medical Journal 2: 501, 1975PubMedCrossRefGoogle Scholar
  4. Amery A, Berhiest W, Croonenberghs J, et al. Double-blind crossover study with a new vasodilator — prazosin — in the treatment of mild hypertension. Excerpta Medica International Congress Series 331: 100–110, 1974Google Scholar
  5. Barry JM, Blank B, Boileau M. Nocturnal penile tumescence with stamps. Urology 15: 171–172, 1980PubMedCrossRefGoogle Scholar
  6. Bauer GE, Baker J, Hunyor SN, et al. Side-effects of antihypertensive treatment: a placebo-controlled study. Clinical Science and Molecular Medicine 55: 341s–344s, 1978Google Scholar
  7. Bauer GE, Hull RD, Stokes GS, et al. The reversibility of side efects of guanethidine. Medical Journal of Australia 1: 930–933, 1973PubMedGoogle Scholar
  8. Beeley L. Drug-induced sexual dysfunction and infertility. Adverse Drug Reactions and Acute Poisoning Reviews 3: 23–42, 1984PubMedGoogle Scholar
  9. Bjorksten O. The physiology of sexual response and classification of sexual dysfunction. In Sciarra (Ed.) Gynecology and obstetrics, Harper and Row, Philadelphia, 1985Google Scholar
  10. Brown JJ, Chinin RH, Dusterdieck GO, et al. Hypertension and hyperaldosteronism with low plasma renin concentration: analysis of a series of eighty-two patients. Proceedings of the Royal Society of Medicine 62: 1258–1260, 1969PubMedGoogle Scholar
  11. Buffum J. Pharmacosexology: the effects of drugs on sexual function: a review. Journal of Psychoactive Drugs 14: 5–44, 1982PubMedCrossRefGoogle Scholar
  12. Buffum JC. Pharmacosexology update: heroin and sexual function. Journal of Psychoactive Drugs 15: 317–318, 1983PubMedCrossRefGoogle Scholar
  13. Buffum J. Pharmacosexology update: prescription drugs and sexual function. Journal of Psychoactive Drugs 18: 97–106, 1986PubMedCrossRefGoogle Scholar
  14. Bulpitt CJ, Dollery CT. Side effects of hypotensive agents evaluated by a self administered questionnaire. British Medical Journal 3: 485–490, 1973PubMedCrossRefGoogle Scholar
  15. Bulpitt CJ, Dollery CT, Carne S. A symptom questionnaire for hypertensive patients. Journal of Chronic Disease 27: 309–323, 1974CrossRefGoogle Scholar
  16. Burnett WG, Chanine RA. Sexual dysfunction as a complication of propranolol therapy in men. Cardiovascular Medicine 4: 811–815, 1979Google Scholar
  17. Caine M, Perlberg S, Shapiro A. Phenoxybenzamine for benign prostatic obstruction. Urology 17: 542–546, 1981PubMedCrossRefGoogle Scholar
  18. Cocores JA, Dackis CA, Gold MS. Sexual dysfunction secondary to cocaine abuse in two patients. Journal of Clinical Psychiatry 47: 384–385, 1986PubMedGoogle Scholar
  19. Coronary Drug Project Report. Clofibrate and niacin in coronary heart disease. Journal of the American Medical Association 231: 360–381, 1975CrossRefGoogle Scholar
  20. Costa FV, Ambrosioni E, Magnani B. Side effects of antihypertensive drugs: incidence and methods of collection. International Journal of Clinical Pharmacology and Biopharmacy 17: 405–409, 1979PubMedGoogle Scholar
  21. Covington SS, Kohen J. Women, alcohol and sexuality: clinical and sociological aspects of alcoholism and substance abuses. Cultural and Sociological Aspects of Alcoholism and Substance Abuse: 41–56, y1984Google Scholar
  22. Dollery CT, Harrington M. Methyldopa in hypertension, clinical and pharmacological studies. Lancet 1: 759–763, 1962PubMedCrossRefGoogle Scholar
  23. Ebringer A, Doyle A, Dawborn J, et al. The use of clonidine (Catapres) in the treatment of hypertension. Medical Journal of Australia 1: 524–526, 1970Google Scholar
  24. Editorial. Drugs that cause sexual dysfunction. Medical Letter 29: 65–73, 1987Google Scholar
  25. Engle G, Burnham SJ, Carter MH. Penile blood pressure in the evaluation of erectile impotence. Fertility and Sterility 30: 687–690, 1978Google Scholar
  26. Franks S, Jacobs HS, Martin N, et al. Hyperprolactinemia and impotence. Clinical Endocrinology 8: 277–287, 1978PubMedCrossRefGoogle Scholar
  27. Ferguson R, Rothenberg R, Nies A. Patient acceptance of guanethidine as therapy for mild to moderate hypertension — a comparison with reserpine. Circulation 54: 32–37, 1976PubMedCrossRefGoogle Scholar
  28. Gantrell N. Increased libido in women receiving trazodone. American Journal of Psychiatry 143: 781–782, 1986Google Scholar
  29. Ghadirian AM, Chovinard G, Annable L. Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients. Journal of Nervous and Mental Diseases 170: 463–467, 1982CrossRefGoogle Scholar
  30. Green M, Berman S. Failure of ejaculation produced by dibenzyline: preliminary report. Connecticut State Medical Journal 18: 30–33, 1954PubMedGoogle Scholar
  31. Hammond DC. Screening for sexual dysfunction. Clinical Obstetrics and Gynecology 27: 732–737, 1984PubMedCrossRefGoogle Scholar
  32. Harrison WM, Robkin JG, Ehrhardt AA, et al. Effects of anti-depressant medication on sexual function: a controlled study. Journal of Clinical Psychopharmacology 6: 144–149, 1986PubMedCrossRefGoogle Scholar
  33. Hayes Jr AH. Clinical pharmacology of current and experimental drugs. In Moser (Ed.) Hypertension — a practical approach, Little, Brown and Co., Boston, 1975Google Scholar
  34. Hoffmann WF. The behavioral side effects of the antihypertensive agents. American Family Physician 23: 213–216, 1981PubMedGoogle Scholar
  35. Hogan MJ, Wallin JD, Baer RM. Antihypertensive therapy and male sexual dysfunction. Psychosomatics 21: 234–237, 1981Google Scholar
  36. Hollifield JW, Sherman K, Vander Swagg R, et al. Proposed mechanisms of propranolol’s antihypertensive effect in essential hypertension. New England Journal of Medicine 295: 68, 1976PubMedCrossRefGoogle Scholar
  37. Horowitz D, Pettinger W, Orvis H, et al. Effects of methyldopa in 50 hypertensive patients. Clinical Pharmacology and Therapeutics 8: 224–234, 1967Google Scholar
  38. Hyypä MT, Falck SC, Aukia H, et al. Neuroendocrine regulation of gonadotropin secretion and sexual motivation after 1-tryptophan administration in man. In Sandier & Gessa (Eds) Sexual behavior, pharmacology and biochemistry, Raven Press, New York, 1975Google Scholar
  39. Jacobson JN. Anorgasmia caused by an MAOI. Correspondence. American Journal of Psychiatry 144: 526, 1987Google Scholar
  40. Johnson P, Kitchin A, Lowther C, et al. Treatment of hypertension with methyldopa. British Medical Journal 1: 133–137, 1966PubMedCrossRefGoogle Scholar
  41. Jones SD. Ejaculatory inhibition with trazodone. Journal of Clinical Psychopharmacology 4: 279–281, 1984PubMedCrossRefGoogle Scholar
  42. Keitner GI, Selub S. Spontaneous ejaculations and neuroleptics. Journal of Clinical Psychopharmacology 3: 34–36, 1983PubMedCrossRefGoogle Scholar
  43. Kedia KR, Persky L. Effect of phenoxybenzamine (Dibenzyline) on sexual function in man. Urology 18: 620–622, 1981PubMedCrossRefGoogle Scholar
  44. Khan A, Camel G, Perry M. Clonidine (Catapres): a new anti-hypertensive agent. Current Therapeutic Research 12: 10–18, 1970PubMedGoogle Scholar
  45. Kinsey AC, Pomerog WB, Morton CE. Sexual behavior in the human male. WB Saunders, Philadelphia, 1948Google Scholar
  46. Kolle GB. Neurohormonal transmission and the autonomic nervous system. In Goodman & Gilman (Eds) The pharmacological basis of therapeutics, New York, Macmillan, 1975Google Scholar
  47. Kowalski A, Stanley RO, Dennerstein L, et al. The sexual side-effects of antidepressant medication: a double-blind comparison of two antidepressants in a non-psychiatric population. British Journal of Psychiatry 147: 413–418, 1985PubMedCrossRefGoogle Scholar
  48. Krane RJ, Siroky MB. Neurophysiology of erection. Urologic Clinics of North America 8: 91–102, 1981PubMedGoogle Scholar
  49. Lamache A, Davost H, et al. Genetic activity of chronic alcoholics. Bull Acad Nat Med 136: 530–532, 1952PubMedGoogle Scholar
  50. Lauwers P, Verstarete M, Joossens JV. Methyldopa in the treatment of hypertension. British Medical Journal 1: 295–300, 1963PubMedCrossRefGoogle Scholar
  51. Laver MC. Sexual behavior patterns in male hypertensives. Australia New Zealand Journal of Medicine 4: 29–31, 1974CrossRefGoogle Scholar
  52. Levine J. The sexual adjustment of alcoholics: a clinical study of a selected sample. QJ Stud Alcohol 16: 675–680, 1955Google Scholar
  53. Levitt JL. Spironolactone therapy and amenorrhea. Journal of the American Medical Association 211: 2014–2015, 1970PubMedCrossRefGoogle Scholar
  54. Loriaux DL, Menard R, Taylor A. Spironolactone and endocrine dysfunction. Annals of Internal Medicine 589 (Suppl.): 630–636, 1976Google Scholar
  55. Lydiard RB, Howell FF, Laraia MT, et al. Sexual side effects of alprazolam. Correspondence. American Journal of Psychiatry 144: 254–255, 1987PubMedGoogle Scholar
  56. Mandell W, Miller CM. Male sexual dysfunction as related to alcohol consumption: a pilot study. Alcoholism: Clinical and Experimental Research 7: 65–69, 1983CrossRefGoogle Scholar
  57. Marberger H. The mechanisms of ejaculation. Basic Life Sciences 4: 99–110, 1974PubMedGoogle Scholar
  58. Masters WM, Johnson VE. Human sexual response, Little, Brown, Boston 1966Google Scholar
  59. Mathews A. Progress in the treatment of female sexual dysfunction. Journal of Psychosomatic Research 27: 165–173, 1983PubMedCrossRefGoogle Scholar
  60. Mirin SM, Meyer RE, Mendelson JH, et al. Opiate use and sexual function. American Journal of Psychiatry 137: 909–915, 1980PubMedGoogle Scholar
  61. Mitchell JE, Popkin MK. Antidepressant drug therapy and sexual dysfunction in men: a review. Journal of Clinical Psychopharmacology 3: 76–79, 1983PubMedCrossRefGoogle Scholar
  62. Mitchell JE, Popkin MK. Antipsychotic drug therapy and sexual dysfunction in men. American Journal of Psychiatry 139: 633–637, 1982PubMedGoogle Scholar
  63. Morley JE. Impotence. American Journal of Medicine 80: 897–905, 1986PubMedCrossRefGoogle Scholar
  64. Moser M, Prandoni A, Orbison J, et al. Clinical experience with sympathetic blocking agents in peripheral vascular disease. Annals of Internal Medicine 38: 1245–1264, 1953PubMedGoogle Scholar
  65. Moss HB, Procci WR. Sexual dysfunction associated with oral antihypertensive medication: a critical survey of the literature. General Hospital Psychiatry 4: 121–129, 1982PubMedCrossRefGoogle Scholar
  66. Mroczek WJ, Leibel BA, Finnerty FA. Comparison of clonidine and methyldopa in hypertensive patients receiving a diuretic-double-blind cross-over study. American Journal of Cardiology 29: 712–717, 1972PubMedCrossRefGoogle Scholar
  67. Munjack DJ. Sex and drugs. Clinical Toxicology 15: 79–89, 1979CrossRefGoogle Scholar
  68. Munjack DJ. The recognition and management of desire phase sexual dysfunction. In Sciarra (Ed.) Gynecology and obstetrics, Harper and Row, Philadelphia, 1985Google Scholar
  69. Munjack DJ, Crocker B. Alprazolam-induced ejaculatory inhibition. Correspondence. Journal of Clinical Psychopharmacology 6: 57–58, 1980CrossRefGoogle Scholar
  70. Nath RL, Menzoian JO, Kaplan KH, et al. The multidisciplinary approach to vasculogenic impotence. Surgery 89: 124–132, 1981PubMedGoogle Scholar
  71. Nazaryan SS. Some of the disorders in the sex life of alcoholics. Zh Eksp Klin Med 16: 88–91, 1976Google Scholar
  72. Nestoros JN, Lekmann HE, Ban TA. Neuroleptic drugs and sexual function in schizophrenia. Modern Problems in Pharmacopsychology 15: 111–130, 1980Google Scholar
  73. Neri A, Aygen M, Zuckerman Z, et al. Subjective assessment of sexual dysfunction of patients on long-term administration of digoxin. Archives of Sexual Behavior 9: 343–347, 1980PubMedCrossRefGoogle Scholar
  74. Neshkov NS. The state of spermatogenesis and sexual function in those who abuse alcohol. Kiev 2: 130–131, 1969Google Scholar
  75. Nickerson M, Collier B. Drugs inhibiting adrenergic nerves and structures innervated by them. In Goodman & Gilman (Eds) The pharmacological basis of therapeutics, Macmillan, New York, 1975Google Scholar
  76. Nies AS. Adverse reactions and interactions limiting the use of antihypertensive drugs. American Journal of Medicine 58: 495–503, 1975PubMedCrossRefGoogle Scholar
  77. Nurnberg HG, Levine PE. Spontaneous remission of MAOI-induced anorgasmia. American Journal of Psychiatry 144: 805–807, 1987PubMedGoogle Scholar
  78. Onesti G, Bock K, Heimsoth V, et al. Clonidine: a new antihypertensive agent. American Journal of Cardiology 28: 74–83, 1971PubMedCrossRefGoogle Scholar
  79. Osborne DR. Propranolol and Peyronie’s disease. Lancet 1: 1111, 1977PubMedCrossRefGoogle Scholar
  80. Papadopoulos C. Cardiovascular drugs and sexuality: a cardiologist’s review. Archives of Internal Medicine 140: 1341–1345, 1980PubMedCrossRefGoogle Scholar
  81. Pape J. Effects of alprenolol in combination with hydralazine in essential hypertension. Acta Medica Scandinavica (Suppl.) 554: 55–62, 1974PubMedGoogle Scholar
  82. Petrie WM. Sexual effects of antidepressants and psychomotor stimulant drugs. Modern Problems in Pharmacopsychology 15: 77–90, 1980Google Scholar
  83. Petursson SR, Wardell WM, Curran JP. National rates and patterns of consumption of antihypertensive drugs in relation to their availability in the United States, the United Kingdom, Australia and New Zealand. Annals of the New York Academy of Sciences 304: 320–330, 1978PubMedCrossRefGoogle Scholar
  84. Pillay VKG. Some side-effects of alpha-methyldopa. South African Medical Journal 50: 625–626, 1976PubMedGoogle Scholar
  85. Pitts NE. The clinical evaluation of prazosin hydrochloride, a new antihypertensive agent. In Cottone (Ed.) Prazosin: evaluation of a new antihypertensive agent, pp. 149–163, Excerpta Medica, Amsterdam, 1974Google Scholar
  86. Pottash ALC, Black HR, Gold MS. Psychiatric complications of antihypertensive medications. Journal of Nervous and Mental Diseases 169: 430–438, 1981CrossRefGoogle Scholar
  87. Powell BJ, Viamontes JA, Brown CS. Alcohol effects on the sexual potency of alcoholic and nonalcoholic males. Alcoholism (Zagret) 10: 78–80, 1974Google Scholar
  88. Prichard BNC, Johnston A, Hill I, et al. Bethanidine, guanethidine and methyldopa in treatment of hypertension: a withinpatient comparison. British Medical Journal 1: 135–144, 1967CrossRefGoogle Scholar
  89. Procci WR, Martin DJ. Preliminary observation of the utility of portable NPT. Archives of Sexual Behavior 13: 569–580, 1984PubMedCrossRefGoogle Scholar
  90. Procci WR, Moss HB, Boyd JL, et al. Consecutive-night reliability of portable nocturnal penile tumescence monitor. Archives of Sexual Behavior 12: 307–316, 1983PubMedCrossRefGoogle Scholar
  91. Rose L, Underwood R, Newmark A, et al. Pathophysiology of spironolactone-induced gynecomastia. Annals of Internal Medicine 87: 398–403, 1977PubMedGoogle Scholar
  92. Sahgal R. Inhibited female orgasm as a side effect of alprazolam. Correspondence. American Journal of Psychiatry 142: 1223–1224, 1985Google Scholar
  93. Schneider J, Kaffarnik H. Impotence in patients treated with clofibrate. Atherosclerosis 21: 445–457, 1975CrossRefGoogle Scholar
  94. Semmens JP, Semmens FJ. Inadequate vaginal lubrication. Medical Aspects of Human Sexuality 12: 58–71, 1978Google Scholar
  95. Shader RI, Elkins R. The effects of anxiety and antipsychotic drugs on sexual behavior. Modern Problems in Pharmacopsychology 15: 91–110, 1980Google Scholar
  96. Shapiro AP, Traub YM. Complications of antihypertensive therapy. American Family Physician 23: 155–163, 1981PubMedGoogle Scholar
  97. Shen WW, Sata LS. Inhibited female orgasm resulting from psychotropic drugs: a clinical review. Journal of Reproductive Medicine 28: 497–499, 1983PubMedGoogle Scholar
  98. Shen WW, Sata LS, Hofstatter L. Thiaridazine and understanding sexual phases in both sexes. Psychiatric Journal of the University of Ottawa 9: 187–190, 1984PubMedGoogle Scholar
  99. Siegel RK. Cocaine and sexual dysfunction: the cause of mama coca. Journal of Psychoactive Drugs 14: 71–74, 1982PubMedCrossRefGoogle Scholar
  100. Smith AD. Causes and classification of impotence. Urologic Clinics of North America 8: 79–89, 1981PubMedGoogle Scholar
  101. Smith DE, Moser C, Wesson DR, et al. A clinical guide to the diagnoses and treatment of heroin-related sexual dysfunction. Journal of Psychoactive Drugs 14: 91–99, 1982PubMedCrossRefGoogle Scholar
  102. Smith DE, Smith N, Buxton ME, et al. PCP and sexual dysfunction. Journal of Psychoactive Drugs 12: 269–273, 1980CrossRefGoogle Scholar
  103. Smith DE, Wesson DR, Aptev Marsh M. Cocaine and alcohol-induced sexual dysfunction in patients with addictive disease. Journal of Psychoactive Drugs 16: 359–361, 1984PubMedCrossRefGoogle Scholar
  104. Spark R, Melby J. Aldosterone in hypertension — the spironolactone response test. Annals of Internal Medicine 69: 685–691, 1968PubMedGoogle Scholar
  105. Stankvskev T, Protic M, Shiskkov A. Disturbances of sexual function in alcoholics. Excerpta Medica Psychiatrica. No. 1183 (Abstract Bulgarian), 1976Google Scholar
  106. Steele TE, Howell EH. Cyproheptadine for imipramine-induced anorgasmia. Correspondence. Journal of Clinical Psychopharmacology 6: 326–327, 1986PubMedCrossRefGoogle Scholar
  107. Tan ETH, Johnson RH, Lambie D, et al. Erectile impotence in chronic alcoholics. Alcoholism: Clinical and Experimental Research 8: 297–301, 1984CrossRefGoogle Scholar
  108. Tenhouten S. Family environment: implications for sexual dysfunction and methaqualone dependence. Journal of Psychoactive Drugs 18: 73–75, 1986PubMedCrossRefGoogle Scholar
  109. Tuchman H, Crumpton C. A comparison of Rauwolfia serpentina compounds, crude root, alseroxylon derivative, and single alkaloid, in the treatment of hypertension. American Heart Journal 49: 742–750, 1955PubMedCrossRefGoogle Scholar
  110. Van Arsdalen KN, Wein AJ. Drug-induced sexual dysfunction in older men. Geriatrics 39(10): 63–70, 1984PubMedGoogle Scholar
  111. Van Thieh DM, Gavaler JS, Sanghul A. Recovery of sexual function in abstinent alcoholic men. Gastroenterology 84: 677–682, 1983Google Scholar
  112. Vejlsgaard V, Christenesen M, Clausen F. Double-blind trial of four hypotensive drugs (methyldopa and three sympatholytic agents). British Medical Journal 2: 598–600, 1967PubMedCrossRefGoogle Scholar
  113. Vijajasenan ME. Alcohol and sex. New Zealand Medical Journal 93: 18–20, 1981Google Scholar
  114. Vlachakis N, Mendlowitz M. Alpha and beta adrenergic receptor blocking agents combined with a diuretic in the treatment of essential hypertension. Journal of Clinical Pharmacology 16: 352–360, 1976PubMedGoogle Scholar
  115. Wallis AA, Bell R, et al. Propranolol and Peyronie’s disease. Lancet 2: 980, 1977PubMedCrossRefGoogle Scholar
  116. Wasserman MD, Pollack C, Spielman AJ, et al. The differential diagnosis of impotence: the measurement of nocturnal penile tumescence. Journal of the American Medical Association 243: 2038–2042, 1980PubMedCrossRefGoogle Scholar
  117. Weiss HB. Physiology of human penile erections. Annals of Internal Medicine 76: 793–799, 1972PubMedGoogle Scholar
  118. Yendt EP, Guay GF, Garcia DA. The use of thiazides in the prevention of renal calculi. Canadian Medical Association Journal 102: 614–620, 1970PubMedGoogle Scholar
  119. Yager J. Bethanechol chloride can reverse erectile and ejaculatory dysfunction induced by tricyclic antidepressants and mazindol: case report. Journal of Clinical Psychiatry 47: 210–211, 1986PubMedGoogle Scholar
  120. Zarren HS, Black PM. Unilateral gynecomastia and impotence during low dose spironolactone administration in men. Military Medicine 140: 417–419, 1975PubMedGoogle Scholar
  121. Zizic V, Friddman V, Despotovic A. Treatment of impotence in alcoholics. Excerpta Medica Psychiatrica, No. 2127 (Abstract Yugoslavian), 1968Google Scholar

Copyright information

© ADIS Press Limited 1988

Authors and Affiliations

  • Duane E. McWaine
    • 1
  • Warren R. Procci
    • 1
  1. 1.Department of PsychiatryHarbor-UCLA Medical CenterTorranceUSA

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