Sexual side effects of novel antipsychotic medications

Wirshing, Donna A; Pierre, Joseph M; Marder, Stephen R; Saunders, C.Scott; Wirshing, William C

doi:10.1016/S0920-9964(01)00271-7

« Previous Next »Schizophrenia Research
Volume 56, Issue 1 , Pages 25-30, 1 July 2002

Sexual side effects of novel antipsychotic medications☆

Donna A Wirshing
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
- Corresponding author. Address: Department of Psychiatry, West Los Angeles Veterans Affairs Medical Centre, Building 210B, Room 15, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. Tel.: +1-310-268-3037; fax: +1-310-312-0572
Joseph M Pierre
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
Stephen R Marder
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
C.Scott Saunders
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
William C Wirshing
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA

Received 20 December 2000; received in revised form 25 May 2001; accepted 29 May 2001.

Abstract

Background: The novel antipsychotic medications offer a more favorable extrapyramidal side effect profile than conventional agents. It is uncertain that the novel antipsychotics have a benefit in terms of sexual side effects.

Methods: We prospectively administered a survey of sexual functioning to 25 male patients with DSM-IV schizophrenia, taking conventional and novel antipsychotics. Contrasts were made between three treatment groups: clozapine (CLOZ), risperidone (RIS), and a combined haloperidol/fluphenazine (HAL/FLU) group.

Results: A decrease in overall sexual functioning was reported in all medication groups (40–71%). The majority of subjects taking RIS or HAL/FLU reported a decline in one or more aspects of sexual functioning. Examining specific aspects of sexual functioning revealed that, a decline in sexual interest was significantly less common on CLOZ compared to RIS (0 vs. 64%; χ²=6.1, df=1, p=0.01) or HAL/FLU (0 vs. 67%; χ²=5.2, df=1, p=0.02), while a decline in the erectile frequency was significantly more common on RIS compared to CLOZ (40 vs. 93%; χ²=6.2, df=1, p=0.01) or HAL/FLU (50 vs. 93%; χ²=4.8, df=1, p=0.03) (0%). For enjoyment of orgasm and ejaculatory volume, significantly fewer CLOZ compared to RIS subjects reported a decline (20 vs. 86%; χ²=7.4, df=1, p=0.01).

Conclusions: Sexual side effects are common clinically pertinent adverse effects associated with both novel and conventional antipsychotic medications. They deserve increased attention in clinical work and future research with emerging antipsychotic drugs.

Keywords: Antipsychotic medication, Clozapine, Risperidone, Haloperidol, Fluphenazine, Sexual side effects