Sexual dysfunction is common in the general population and even more common in the mentally or
medically ill. Because mentally ill patients often receive psychotropics, many of which affect sexual functioning,
a patient’s pre-existing sexual difficulties are often compounded, and these adverse effects may
contribute to psychological difficulties or medication discontinuation. The effects of antidepressants,
antipsychotics, mood stabilizers and anxiolytics on sexual functioning are critically reviewed. When possible,
the types of sexual dysfunction (e.g. desire, arousal, or orgasm) induced by the drug is described.
Treatments for drug-induced sexual function are described, but few controlled studies show benefit.
Only sildenafil stands as a convincing treatment for drug-induced sexual dysfunction. The paper focuses
on the placebo-controlled clinical trials that specifically evaluated sexual functioning in patients treated
with psychotropics. Controlled studies are few for all the agents, though best for the antidepressants and
antipsychotics. The exact magnitude and phase of sexual functioning affected remains to be elucidated
for most psychotropic drugs. Although all phases of sexual functioning may be impaired by psychotropics,
selective serotonin reuptake inhibitor antidepressants appear to primarily affect orgasm, while
antipsychotics primarily affect desire. There is insufficient evidence to make conclusions about the anxiolytics
or mood stabilizers.
Copyright / Drug Dosage
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