Loss of Libido in a Woman With Schizophrenia (original) (raw)
Related papers
Sao Paulo Medical Journal, 2006
INTRODUCTION: Sexual dysfunction frequently occurs in patients with schizophrenia under antipsychotic therapy, and the presence of sexual side effects may affect compliance. The aim of this study was to review and describe clinical findings relating to the appropriate management of such dysfunctions. MATERIAL AND METHODS: The research was carried out through Medline (from 1966 to March 2005), PsycInfo (from 1974 to March 2005), and Cochrane Library (from 1965 to March 2005) and included any kind of study, from case reports to randomized trials. RESULTS: The most common sexual dysfunctions found in the literature were libido decrease, difficulties in achieving and maintaining erection, ejaculatory dysfunction, orgasmic dysfunction, and menstrual irregularities. Thirteen papers were found: eight of them were open-label studies, four were descriptions of cases, and only one was a randomized clinical trial. All of them were short-term and had small sample sizes. The agents used were: br...
Female Sexual Dysfunction and Schizophrenia: A Clinical Review
Journal of Psychosexual Health
Female sexual dysfunction (FSD) is understudied and unexplored in clinical practice. There is a need for psychiatrists to acknowledge the same and explore this symptom in patients with schizophrenia. The following article is a clinical review that looks at various facets of FSD in relation to schizophrenia. The various types of FSD seen in schizophrenia are elaborated and factors that affect the same are discussed. The role of various factors and antipsychotic-induced FSD is also discussed. The role of estrogens in women with schizophrenia from a clinical and sexual perspective, the role of oral contraceptives in schizophrenia, schizophrenia and pregnancy related complications along with menopause, and its effect on schizophrenia and sexual function in these patients are discussed. The neurobiology of FSD is explored briefly along with the role of female sexuality in recovery and enhancing outcome in schizophrenia is also elaborated. The victimization of female patients with schizop...
Sexuality and Schizophrenia: A Review
Schizophrenia Bulletin, 2004
Sexual functioning has received little attention as an important aspect of patient care for those suffering from severe mental disorders such as schizophrenia. Yet, it has been implicated as one of the major factors contributing to noncompliance with antipsychotic medications and is documented by people with schizophrenia to be one of the areas of treatment with the most unmet needs. A stronger focus on sexuality and preventing sexual dysfunction in schizophrenia would likely be a major benefit for improving treatment. This review will describe possible mechanisms for sexual dysfunction, describe sexual disturbances that have been documented in the literature of people who have schizophrenia, and summarize and discuss assessment measures available. Moreover, a focus on second-generation antipsychotics (SGA) and their association with sexual functioning is described. Each SGA (clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole) will be described for its prolactin effects, documented sexual disturbances associated with use, and product labeling regarding sexual function. Treatment options and psychosocial issues pertaining to sexuality also are presented.
Psychiatry International, 2021
Psychiatric disorders, in general, have a high prevalence of sexual problems, whether from the psychopathology of the disorder itself, pre-existing or co-morbid sexual disorder or from side effects of the treatment for mental disorders. Many patients report an already existing sexual dysfunction at the onset of diagnosis. The risk association for developing sexual dysfunction in patients with schizophrenia includes antipsychotic use and resulting hyperprolactinemia, age, gender, and disease severity. Medication side effects lead to nonadherence, and relapses lead to structural changes in the brain, treatment resistance, and worsening of symptoms. Findings in certain studies propose serum prolactin and thyroid-stimulating hormone measurement as a tool for assessing patients with schizophrenia for sexual dysfunction. Regarding specific symptoms, females especially reported decreased desire at baseline and galactorrhea after treatment. The findings of this review, therefore, suggest th...
The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP), 2005
The prevalence of sexual dysfunction in schizophrenia patients was investigated as part of this large (n = 7655), prospective, international (27 countries) study. Based on patient reports, sexual dysfunction affected approx. 50% of patients and the prevalence of complaints varied significantly between regions (p < 0.0001). The prevalence of sexual dysfunction, as perceived by psychiatrists, also varied significantly across regions (p < 0.0001). Psychiatrists significantly underestimated the presence of impotence/sexual dysfunction (p < 0.0001) and loss of libido (p < 0.0001), compared to reports from patients. The frequency of sexual dysfunction was significantly higher in patients who had been using prolactin-elevating antipsychotics prior to study entry, compared to those who had been treated with prolactin-sparing antipsychotics (patient reports, p = 0.002; psychiatrist perception, p = 0.0004). This study has shown that the prevalence of sexual dysfunction is high in ...
Frequency of Sexual Dysfunction in Patients with a Psychotic Disorder Receiving Antipsychotics
Journal of Sexual Medicine, 2010
Introduction. Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited.Aim. To evaluate the frequency of sexual dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions.Methods. Subjects included were sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history.Main Outcome Measure. Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex).Results. All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited sexual dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with sexual dysfuntion spontaneously reported it. Among the patients exhibiting sexual dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females’ sexual funtioning, the severity and tolerance of sexual dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73–14.89) and conventionals, depot (OR 4.57, 95% CI 1.72–12.13) and nondepot (OR 4.92, 95% CI 1.43–16.93), showed a significant increased risk of sexual dysfunction.Conclusions. Our results show that sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients. Montejo AL, Majadas S, Rico-Villademoros F, LLorca G, de la Gándara J, Franco M, Martín-Carrasco M, Aguera L, and Prieto N. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics. J Sex Med 2010;7:3404–3413.
2018
Background: the relationship between sexuality and schizophrenia is complex. It may be related to both the psychopathology and the pharmacotherapy, as the sexual functions may be affected by symptoms itself, living with a severe chronic mental health illness, and the adverse effects of antipsychotics or other medications. Systematic studies have revealed that sexual dysfunction is highly prevalent in both untreated and treated schizophrenia patients, affecting 30–80% of women and 45–80% of men. The prevalence of sexual dysfunction may be higher in patients with schizophrenia than in patients treated for other mental disorders. Aim of the Work: to compare a group of females with Schizophrenia to healthy female control group regarding frequency and type of sexual dysfunction. Patients and Methods: this study was sought to extend our knowledge about the association of schizophrenia and its treatment with sexuality problems. It was done at Institute of Psychiatry, Faculty of Medicine, A...
The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings
Schizophrenia Bulletin, 2015
A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.