Sexual side-effects of antidepressant and antipsychotic drugs

被引:113
作者
Montejo, Angel L. [1 ,2 ,3 ]
Montejo, Laura [3 ]
Navarro-Cremades, Felipe [4 ]
机构
[1] Univ Hosp Salamanca, Dept Nursing, Salamanca, Spain
[2] Univ Hosp Salamanca, Dept Psychiat, Salamanca, Spain
[3] Univ Salamanca, IBSAL Neurosci Area, E-37008 Salamanca, Spain
[4] Miguel Hernandez Univ, Dept Clin Med, Alacant, Spain
关键词
antidepressant; antipsychotic; compliance; quality of life; sexual dysfunction; MAJOR DEPRESSIVE DISORDER; DOUBLE-BLIND; REUPTAKE INHIBITORS; PROLACTIN LEVELS; PRSEXDQ-SALSEX; DYSFUNCTION; PLACEBO; EFFICACY; PAROXETINE; SEROTONIN;
D O I
10.1097/YCO.0000000000000198
中图分类号
R749 [精神病学];
学科分类号
100204 [神经病学];
摘要
Purpose of review Psychotropic-related sexual dysfunction is a quite frequent issue in clinical practice, mainly in chronic treatments affecting both quality of life and compliance. Recent findings In the last decade fortunately antidepressants and antipsychotic compounds have been deeply screened in order to identify sexual adverse events that were commonly underdiagnosed and previously underestimated by clinicians and perhaps by pharmaceutical companies as well. Some differences in the mechanism of action are the nucleus of this poorly tolerated adverse event. All antidepressants with serotonergic activity can cause mild to severe sexual dysfunction such as decreased libido and delayed orgasm frequently (> 60%) or anorgasmia and arousal difficulties sometimes (30%). In contrast, noradrenergic, dopaminergic, or melatonergic antidepressants do not cause sexual dysfunction but perhaps the clinical profile of patients receiving these compounds could be different. Antipsychotics that highly increase prolactin levels and strongly block dopamine receptors could be related to sexual dysfunction as well. Unfortunately, these dysfunctions are present during the long term after the antipsychotic onset to provide continued symptom control and enable recovery. Young patients suffering psychosis and concomitant sexual dysfunction (erectile and/or orgasmic difficulties) tend to show poor compliance in chronic treatments affecting the outcomes. Summary The implications of psychotropic-related sexual dysfunction in clinical practice are relevant mainly in patients under long-term treatment with previous satisfactory sexual life. Implications for future research about sexual dysfunction in all new treatments should be strongly taken into account.
引用
收藏
页码:418 / 423
页数:6
相关论文
共 56 条
[1]
Neural Correlates of Antidepressant-Related Sexual Dysfunction: A Placebo-Controlled fMRI Study on Healthy Males Under Subchronic Paroxetine and Bupropion [J].
Abler, Birgit ;
Seeringer, Angela ;
Hartmann, Antonie ;
Groen, Georg ;
Metzger, Coraline ;
Walter, Martin ;
Stingl, Julia .
NEUROPSYCHOPHARMACOLOGY, 2011, 36 (09) :1837-1847
[2]
Safety, tolerability, and efficacy of vortioxetine (Lu AA21004) in major depressive disorder: results of an open-label, flexible-dose, 52-week extension study [J].
Alam, Mohammed Y. ;
Jacobsen, Paula L. ;
Chen, Yinzhong ;
Serenko, Michael ;
Mahableshwarkar, Atul R. .
INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY, 2014, 29 (01) :36-44
[3]
Pharmacology and clinical potential of vortioxetine in the treatment of major depressive disorder [J].
Alvarez, Enric ;
Perez, Victor ;
Artigas, Francesc .
NEUROPSYCHIATRIC DISEASE AND TREATMENT, 2014, 10 :1297-1307
[4]
[Anonymous], 2014, European Psychiatry, DOI DOI 10.1016/S0924-9338(14)78746-2
[5]
[Anonymous], 2013, DEPRESS RES TREAT
[6]
Resolution of sexual dysfunction during acute treatment of major depression with milnacipran [J].
Baldwin, David ;
More, Ricardo A. ;
Brlley, Mike .
HUMAN PSYCHOPHARMACOLOGY-CLINICAL AND EXPERIMENTAL, 2008, 23 (06) :527-532
[7]
Antidepressant drugs and sexual dysfunction [J].
Baldwin, David S. ;
Foong, Thomas .
BRITISH JOURNAL OF PSYCHIATRY, 2013, 202 (06) :396-397
[8]
Basson R, 2010, J SEX MED 2, V7, P374
[9]
Besnard I., 2014, Encephale, V40, P86, DOI [10.1016/j.encep.2012.03.002, DOI 10.1016/J.ENCEP.2012.03.002]
[10]
Sexual side effects of serotonergic antidepressants: Mediated by inhibition of serotonin on central dopamine release? [J].
Bijlsma, Elisabeth Y. ;
Chan, Johnny S. W. ;
Olivier, Berend ;
Veening, Jan G. ;
Millan, Mark J. ;
Waldinger, Marcel D. ;
Oosting, Ronald S. .
PHARMACOLOGY BIOCHEMISTRY AND BEHAVIOR, 2014, 121 :88-101