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Medication-Associated Sexual Dysfunction in Patients with Mental Illness

  • Alessandro Cuomo
  • Arianna Goracci
  • Andrea Fagiolini
Chapter
Part of the Trends in Andrology and Sexual Medicine book series (TASM)

Abstract

Sexual dysfunction (SD) is a frequent and distressing side effect of many psychotropic medications, including serotonergic antidepressants, antipsychotic medications, and mood stabilizers. Psychotropic medications may negatively influence any of the areas of sexual functioning, including libido, arousal, and orgasm. Sexual dysfunction is a threat to patients’ quality of life and frequently affects partners’ quality of life as well. Yet, SD is often underestimated both in clinical trials and in clinical practice. In fact, many patients feel embarrassed to spontaneously discuss side effects that involve sexual functions, and many study designs and clinicians rely only on spontaneous reports. This chapter provides an overview of medication-induced SD and examines the prevalence, clinical characteristics, causes, and treatment options for this burdensome condition.

References

  1. 1.
    Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, Laumann EO, Lizza E, et al. Epidemiology/risk factors of sexual dysfunction. J Sex Med. 2004;1(1):35–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537–44. Erratum in: JAMA 1999; 281: 1174.CrossRefPubMedGoogle Scholar
  3. 3.
    Johannes CB, Clayton AH, Odom DM, Rosen RC, Russo PA, Shifren JL, et al. Distressing sexual problems in United States women revisited: prevalence after accounting for depression. J Clin Psychiatry. 2009;70:1698–706.CrossRefPubMedGoogle Scholar
  4. 4.
    Ernst C, Foldenyi M, Angst J. The Zurich Study: XXI. Sexual dysfunctions and disturbances in young adults. Eur Arch Psychiatry Clin Neurosci. 1993;243:179–88.CrossRefPubMedGoogle Scholar
  5. 5.
    Angst J. Sexual problems in healthy and depressed patients. Int Clin Psychopharmacol. 1998;13(suppl 6):S1–3.CrossRefPubMedGoogle Scholar
  6. 6.
    Rozan GH, Tuchin T, Kurland ML. Some implications of sexual activity for mental illness. Ment Hyg. 1971;55:318–23.PubMedGoogle Scholar
  7. 7.
    Aizenberg D, Aizenberg D, Zemishlany Z, Dorfman-Etrog P, Weizman A. Sexual dysfunction in male schizophrenic patients. J Clin Psychiatry. 1995;56:137–41.PubMedGoogle Scholar
  8. 8.
    Bhui K, Puffet A, Herriot P. A survey of sexual problems amongst psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol. 1995;30:73–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Teusch L, Scherbaum N, Böhme H, Bender S, Eschmann-Mehl G, Gastpar M. Different patterns of sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. Results of an investigation by semistructured interview of schizophrenic and neurotic patients and methadone substituted opiate addicts. Pharmacopsychiatry. 1995;28:84–92.CrossRefPubMedGoogle Scholar
  10. 10.
    Olfson M, Uttaro T, Carson WH, Tafesse E. Male sexual dysfunction and quality of life in schizophrenia. J Clin Psychiatry. 2005;66:331–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Montejo-González AL, Llorca G, Izquierdo JA, Ledesma A, Bousoño M, Calcedo A, et al. SSRI induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther. 1997;23:176–94.CrossRefPubMedGoogle Scholar
  12. 12.
    Bonierbale M, Lançon C, Tignol J. The ELIXIR study: evaluation of sexual dysfunction in 4557 depressed patients in France. Curr Med Res Opin. 2003;19:114–24.CrossRefPubMedGoogle Scholar
  13. 13.
    Just MJ. The influence of atypical antipsychotic drugs on sexual function. Neuropsychiatr Dis Treat. 2015;11:1655–61.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Baldwin D, Mayers A. Sexual side-effects of antidepressant and antipsychotic drugs. Adv Psychiatr Treat. 2013;9:202–10.CrossRefGoogle Scholar
  15. 15.
    Nelson E. Sex and antidepressants: when to switch drugs or try an antidote. Curr Psychiatry. 2004;3:53–66.Google Scholar
  16. 16.
    Ramirez G, Butcher DE, Newton JL, Brueggemeyer CD, Moon J, Gomez-Sanchez C. Bromocriptine and the hypothalamic hypophyseal function in patients with chronic renal failure on chronic haemodialysis. Am J Kidney Dis. 1985;6:111–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Segraves RT. Effects of psychotropic drugs on human erection and ejaculation. Arch Gen Psychiatry. 1989;46:275–84.CrossRefPubMedGoogle Scholar
  18. 18.
    Waldinger MD. Psychiatric disorders and sexual dysfunction. Handb Clin Neurol. 2015;130:469–89.CrossRefPubMedGoogle Scholar
  19. 19.
    Freeman ME, Kanyicska B, Lerant A, Nagy G. Prolactin: structure, function, and regulation of secretion. Physiol Rev. 2000;80:1523–63.CrossRefPubMedGoogle Scholar
  20. 20.
    Ben Zion IZ, Tessler R, Cohen L, Lerer E, Raz Y, Bachner-Melman R, et al. Polymorphisms in the dopamine D4 receptor gene (DRD4) contribute to individual differences in human sexual behavior: desire, arousal and sexual function. Mol Psychiatry. 2006;11:782–6.CrossRefGoogle Scholar
  21. 21.
    Bishop JR, Ellingrod VL, Akroush M, Moline J. The association of serotonin transporter genotypes and selective serotonin reuptake inhibitor (SSRI)-associated sexual side effects: possible relationship to oral contraceptives. Hum Psychopharmacol. 2009;24:207–15.CrossRefPubMedGoogle Scholar
  22. 22.
    Clayton AH, Alkis AR, Parikh NB, Votta JG. Sexual dysfunction due to psychotropic medications. Psychiatr Clin North Am. 2016;39:427–63.CrossRefPubMedGoogle Scholar
  23. 23.
    Bishop JR, Moline J, Ellingrod VL, Schultz SK, Clayton AH. Serotonin 2A-1438 G/A and G-protein Beta 3 subunit C825T polymorphisms in patients with depression and SSRI associated sexual side effects. Neuropsychopharmacology. 2006;31:2281–8.PubMedGoogle Scholar
  24. 24.
    Zourková A, Hadasová E. Relationship between CYP 2D6 metabolic status and sexual dysfunction in paroxetine treatment. J Sex Marital Ther. 2002;28:451–61.CrossRefPubMedGoogle Scholar
  25. 25.
    Zourková A, Cesková E, Hadasová E, Ravcuková B. Links among paroxetine induced sexual dysfunctions, gender, and CYP2D6 activity. J Sex Marital Ther. 2007;33:343–55.CrossRefPubMedGoogle Scholar
  26. 26.
    Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry. 2001;62(suppl 3):10–21.PubMedGoogle Scholar
  27. 27.
    Clayton AH, Pradko JF, Croft HA, Montano CB, Leadbetter RA, Bolden-Watson C, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63:357–66.CrossRefPubMedGoogle Scholar
  28. 28.
    Clayton A, Kornstein S, Prakash A, Mallinckrodt C, Wohlreich M. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med. 2007;4:917–29.CrossRefPubMedGoogle Scholar
  29. 29.
    Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychoparmacol. 2009;29:259–66.CrossRefGoogle Scholar
  30. 30.
    La Torre A, Giupponi G, Duffy D, Conca A. Sexual dysfunction related to psychotropic drugs: a critical review–part I: antidepressants. Pharmacopsychiatry. 2013;46:191–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Wallace M. Real progress – the patient’s perspective. Int Clin Psychopharmacol. 2001;16(suppl 1):S21–4.CrossRefPubMedGoogle Scholar
  32. 32.
    Smith S, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002;181:49–55.CrossRefPubMedGoogle Scholar
  33. 33.
    Petty RG. Prolactin and antipsychotic medications: mechanism of action. Schizophr Res. 1999;35(suppl):S67–73.CrossRefPubMedGoogle Scholar
  34. 34.
    Baldwin D, Birtwistle J. Schizophrenia, antipsychotic drugs and sexual function. Prim Care Psychiatry. 1997;3:115–23.Google Scholar
  35. 35.
    Patel AG, Mukherji K, Lee A. Priapism associated with psychotropic drugs. Br J Hosp Med. 1996;55:315–9.PubMedGoogle Scholar
  36. 36.
    Mitchell J, Popkin M. The pathophysiology of sexual dysfunction associated with antipsychotic drug therapy in males: a review. Arch Sex Behav. 1983;12:173–83.CrossRefGoogle Scholar
  37. 37.
    Ghadirian AM, Chouinard G, Annable L. Sexual dysfunction and plasma prolactin levels in neuroleptic treated schizophrenic outpatients. J Nerv Ment Dis. 1982;170:463–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Aizenberg D, Modai I, Landa A, Gil-Ad I, Weizman A. Comparison of sexual dysfunction in male schizophrenic patients maintained on treatment with classical antipsychotics versus clozapine. J Clin Psychiatry. 2001;62:541–4.CrossRefPubMedGoogle Scholar
  39. 39.
    Bobes J, Garc A-Portilla MP, Rejas J, Hern Ndez G, Garcia-Garcia M, Rico-Villademoros F, et al. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. J Sex Marital Ther. 2003;29:125–47.CrossRefPubMedGoogle Scholar
  40. 40.
    Tran PV, Hamilton SH, Kuntz AJ, Potvin JH, Andersen SW, Beasley C Jr, et al. Double blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol. 1997;17:407–18.CrossRefPubMedGoogle Scholar
  41. 41.
    Rosen SI, Hanno PM. Clozapine-induced priapism. J Urol. 1992;148:876–7.CrossRefPubMedGoogle Scholar
  42. 42.
    Emes CE, Milson RC. Risperidone-induced priapism. Can J Psychiatry. 1994;39:315–6.PubMedGoogle Scholar
  43. 43.
    Deirmenjian JH, Erhart SM, Wirshing DA, Spellberg BJ, Wirshing WC. Olanzapine-induced reversible priapism: a case report. J Clin Psychopharmacol. 1998;18:351–3.CrossRefPubMedGoogle Scholar
  44. 44.
    Compton MT, Saldivia A, Berry SA. Recurrent priapism during treatment with clozapine and olanzapine. Am J Psychiatry. 2000;157:659.CrossRefPubMedGoogle Scholar
  45. 45.
    Songer DA, Barclay JC. Olanzapine-induced priapism. Am J Psychiatry. 2001;158:2087–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Rothschild AJ. Selective serotonin reuptake inhibitor-induced sexual dysfunction: efficacy of a drug holiday. Am J Psychiatry. 1995;152:1514–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Clayton AH, Croft HA, Horrigan JP, Wightman DS, Krishen A, Richard NE, et al. Bupropion extended release compared with escitalopram: effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies. J Clin Psychiatry. 2006;67:736–46.CrossRefPubMedGoogle Scholar
  48. 48.
    Thase ME, Clayton AH, Haight BR, Thompson AH, Modell JG, Johnston JA. A double-blind comparison between bupropion XL and venlafaxine XR: sexual functioning, antidepressant efficacy, and tolerability. J Clin Psychopharmacol. 2006;26:482–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Jacobsen PL, Mahableshwarkar AR, Chen Y, Chrones L, Clayton AH. Effect of vortioxetine vs. escitalopram on sexual functioning in adults with well-treated major depressive disorder experiencing SSRI-induced sexual dysfunction. J Sex Med. 2015;12:2036–48.CrossRefPubMedGoogle Scholar
  50. 50.
    Bang-Andersen B, Ruhland T, Jorgensen M, Smith G, Frederiksen K, Jensen KG, et al. Discovery of 1-[2-(2,4-dimethylphenylsulfanyl)phenyl]piperazine (Lu AA21004): a novel multimodal compound for the treatment of major depressive disorder. J Med Chem. 2011;54:3206–21.CrossRefPubMedGoogle Scholar
  51. 51.
    Ereshefsky L, Saragoussi D, Despiégel N, Hansen K, François C, Maman K. The 6-month persistence on SSRIs and associated economic burden. J Med Econ. 2010;13:527–36.CrossRefPubMedGoogle Scholar
  52. 52.
    Kennedy SH, McCann SM, Masellis M, McIntyre RS, Raskin J, McKay G, et al. Combining bupropion SR with venlafaxine, paroxetine, or fluoxetine: a preliminary report on pharmacokinetic, therapeutic, and sexual dysfunction effects. J Clin Psychiatry. 2002;63:181–6.CrossRefPubMedGoogle Scholar
  53. 53.
    Clayton AH, Warnock JK, Kornstein SG, Pinkerton R, Sheldon-Keller A, McGarvey EL. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. 2004;65:62–7.CrossRefPubMedGoogle Scholar
  54. 54.
    Nurnberg HG, Gelenberg A, Hargreave TB, Harrison WM, Siegel RL, Smith MD. Efficacy of sildenafil citrate for the treatment of erectile dysfunction in men taking serotonin reuptake inhibitors. Am J Psychiatry. 2001;158:1926–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S. Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. JAMA. 2003;289:56–64.CrossRefPubMedGoogle Scholar
  56. 56.
    Fava M, Nurnberg HG, Seidman SN, Holloway W, Nicholas S, Tseng LJ, et al. Efficacy and safety of sildenafil in men with serotonergic antidepressant-associated erectile dysfunction: results from a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2006;67:240–6.CrossRefPubMedGoogle Scholar
  57. 57.
    Nurnberg HG, Hensley PL, Heiman JR, Croft HA, Debattista C, Paine S. Sildenafil treatment of women with antidepressant associated sexual dysfunction: a randomized controlled trial. JAMA. 2008;300:395–404.CrossRefPubMedGoogle Scholar
  58. 58.
    Evliyaoğlu Y, Yelsel K, Kobaner M, Alma E, Saygılı M. Efficacy and tolerability of tadalafil for treatment of erectile dysfunction in men taking serotonin reuptake inhibitors. Urology. 2011;77:1137–41.CrossRefPubMedGoogle Scholar
  59. 59.
    Martyn-St James M, Cooper K, Ren S, Kaltenthaler E, Dickinson K, Cantrell A, et al. Phosphodiesterase type 5 inhibitors for premature ejaculation: a systematic review and meta-analysis. Eur Urol Focus. 2017;3:119–29.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Gross MD. Reversal by bethanechol of sexual dysfunction caused by anticholinergic antidepressants. Am J Psychiatry. 1982;139:1193–4.CrossRefPubMedGoogle Scholar
  61. 61.
    Sovner R. Treatment of tricyclic antidepressant-induced orgasmic inhibition with cyproheptadine. J Clin Psychopharmacol. 1984;4:169.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Alessandro Cuomo
    • 1
  • Arianna Goracci
    • 1
  • Andrea Fagiolini
    • 1
  1. 1.Department of Molecular and Developmental Medicine, Division of Psychiatry, Ospedale le Scotte, Clinica PsichiatricaUniversity of SienaSienaItaly

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