Sexual dysfunction in schizophrenia: focus on recent evidence.

BACKGROUND: Antipsychotic medications are known to be commonly associated with sexual dysfunction. Sexual dysfunction is estimated to affect 30-80% of patients with schizophrenia and is a major cause of poor quality of life. However, few comparative studies on the sexual dysfunction effects associated with antipsychotic medication have been published and the effects of the newer atypical antipsychotics have been largely unexamined.

OBJECTIVE: This review aims to examine the latest evidence regarding the sexual function effects of different antipsychotic medications, particularly the newer prolactin-sparing drugs, quetiapine and aripiprazole, in patients with schizophrenia and schizoaffective psychosis.

METHODS: A literature search was conducted within PubMed/MEDLINE using the terms risperidone, haloperidol, clozapine, olanzapine, ziprasidone, quetiapine, aripiprazole; sexual dysfunction; schizophrenia. The results were limited to studies published since 2002.

RESULTS: Recently published studies show that the relative impact of antipsychotics on sexual dysfunction can be summarised as risperidone > typical antipsychotics (haloperidol) > olanzapine > quetiapine > aripiprazole.

CONCLUSIONS: The availability of prolactin-sparing antipsychotics should enable psychiatrists to consider and manage proactively the sexual function consequences of pharmacological intervention, thereby improving sexual side effects, which may lead to improved treatment adherence and psychiatric outcome in patients with schizophrenia.