Sexual dysfunction in patients with schizophrenia on antipsychotic medication

2007 ◽  
Vol 22 (5) ◽  
pp. 328-333 ◽  
Author(s):  
Alp Üçok ◽  
Cem İncesu ◽  
Tamer Aker ◽  
Şahap Erkoç
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Desire ◽  
Rating Scale ◽  
Sexual Experience ◽  
Regression Analyses ◽  
Antipsychotic Therapy ◽  
Conventional Antipsychotics ◽  
Low Sexual Desire ◽  
Dsm Iv ◽  
Severity Of The Disease

AbstractObjectiveThe objective of this study was to determine the prevalence of sexual dysfunction in patients with schizophrenia under antipsychotic therapy and to investigate the effect of various parameters on sexual dysfunction.MethodA total of 827 stabilized outpatients who met DSM-IV criteria for schizophrenia, were recruited in the study. Arizona Sexual Experience Scale (ASEX) and the subscale on sexual function of the UKU Side Effects Rating Scale were applied at a single interview.ResultsIn total, 52.6% of the patients had sexual dysfunction, 54.2% reported a low sexual desire and 41.7% reported problems in having an orgasm. Erectile dysfunction and ejaculation problems were seen in 48.1% and 64.2% of the men, respectively; amenorrhea was seen in 24.9% of the women. ASEX score and severity of disease were found to be correlated (p = 0.02). Higher ASEX scores were observed in patients who smoked (p = 0.01). Men receiving atypical monotherapy had lower ASEX scores than those receiving a combination of atypical and conventional antipsychotics (p = 0.017). Patients on combination therapy had more ejaculation problems than the atypical group (p = 0.001). Low sexual desire was more prevalent among women using conventional drugs than those on atypical drugs (p = 0.004). In linear regression analyses, ASEX was affected significantly and independently by the severity of the disease only in men (p = 0.005).ConclusionOur results show that sexual dysfunction is widespread among patients with schizophrenia on antipsychotic medications.

Sexual Dysfunction in Patients on Antipsychotic Therapy Vladica Sibinovic Psychiatry Clinic CC NIS

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Sibinovic
Keyword(s):  
Erectile Dysfunction ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Sexual Experience ◽  
Typical Antipsychotic ◽  
Antipsychotic Therapy ◽  
Icd 10 ◽  
Ejaculatory Dysfunction

The aim of this study was to determine difference in sexual dysfunction between 137 stabilized male outpatients who met ICD-10 criteria for acute and transient psychotic disorders (F 23) and schizophrenia (F 20) under therapy atypical and typical antipsychotic.Arizona Sexual Experience Scale (ASEX) and the subscale on sexual function of the UKU Side Effects Rating Scale were applied at a single interview.Sexual dysfunction was observed in 55, 47% (76 patients). We find higher ASEX and UKU score in patient with schizophrenia under therapy atypical and typical antipsychotic (p=0, 01). in patients with schizophrenia under typical antipsychotic, orgastic dysfunction (p< 0, 05) is more common.Ejaculatory dysfunction and erectile dysfunction are also high in that group (p< 0, 05).Therapies with atypical and typical antipsychotic have the same effects on increased or diminished sexual desire in bout group of patients.In patients with schizophrenia under typical antipsychotic there is higher ASEX score then in patients under atypical antipsychotic (p< 0, 05). Patients with acute and transient psychotic disorders do not have difference on level of sexual dysfunction in correlation with treated by atypical and typical antipsychotic.Results show that sexual dysfunction is more common in patients with schizophrenia under therapy with typical antipsychotic. in group of patients with acute and transient psychotic disorders there is no difference betven therapy atypical or typical antipsychotic in sexual dysfunction.

scholarly journals Prevalence and Type of Sexual Dysfunction in Female Patients Receiving Antidepressant Medications

2020 ◽  
Vol 2 (2) ◽  
pp. 158-164
Author(s):  
Sandeep Grover ◽  
Natasha Kate ◽  
Eepsita Mishra ◽  
Ajit Avasthi
Keyword(s):  
Medication Adherence ◽  
Sexual Dysfunction ◽  
Rating Scale ◽  
Sexual Experience ◽  
Interpersonal Relationship ◽  
Cutoff Score ◽  
Medical Illness ◽  
Cross Sectional ◽  
Female Patients ◽  
Antidepressant Medications

Aim: To assess the prevalence and typology of sexual dysfunction in female patients receiving antidepressant medications using the Arizona Sexual Experience Scale (ASEX). Method: A cross-sectional design was employed. A total of 71 married women with various psychiatric disorders receiving antidepressants for at least 3 months’ were evaluated on ASEX, Brief Adherence Rating Scale, Medication Adherence Questionnaire, and Global Assessment of Functioning (GAF) scale. Subjects with a history of sexual dysfunction prior to psychotropic intake, menopause, severe interpersonal relationship problems with spouse, or chronic medical illness were excluded. Results: The study sample had the mean age of 37.35 (SD: 6.82) years. More than four-fifth (80.2%) of patients had sexual dysfunction as per the ASEX. Using a cutoff score of 4 or more to define sexual dysfunction in various domains, decreased desire was seen in 81.7%, reduced arousal was seen in 80.3%, poor vaginal lubrication was seen in 76.1%, reduced satisfaction was seen in 57.7%, and reduced ability to reach orgasm was seen in 50.7%. Despite this, few patients (13.3%) discussed their sexual dysfunction with their treating psychiatrist. Sexual dysfunction did not influence the medication adherence. Conclusions: Sexual dysfunction is quite prevalent in female patients receiving antidepressant medications; however, this is not adequately discussed by the patient or the treating psychiatrist.

scholarly journals Female Sexual Dysfunction in Patients Treated with Antidepressants: A Comparison between Agomelatine and Escitalopram

2021 ◽  
pp. 196-204
Author(s):  
Virinder Kaur ◽  
Ng Chong Guan ◽  
Jesjeet Singh Gill ◽  
Low Sue-Yin
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Desire ◽  
Female Sexual Dysfunction ◽  
Rating Scale ◽  
Psychiatric Clinic ◽  
Depression Severity ◽  
Cross Sectional ◽  
Care Clinic ◽  
Significant Difference ◽  
Desire Disorder

Aim: This study aims to determine and compare the prevalence of Female Sexual Dysfunction (FSD) between patients on escitalopram and agomelatine, as well as to investigate possible factors associated with their usage. Study Design: Cross-sectional. Place and Duration of Study: Psychiatric Day Care Clinic, Department of Psychological Medicine, University Malaya Medical Centre (UMMC), Malaysia, between November 1, 2020 until February 1, 2021. Methodology: This study is a cross-sectional study involving 66 women with depression from the outpatient psychiatric clinic of a university hospital; 35 of whom were prescribed with escitalopram and 31 with agomelatine. The subjects were in remission and had no significant signs or symptoms of depression for at least 2 months. The prevalence of FSD between the two groups were compared after adjusting for underlying depression severity. Results: This study showed that the overall prevalence rate of FSD was 33.3%, with the prevalence being higher for those on escitalopram (42.9%) than those on agomelatine (22.6%), but did not achieve statistical significance (P=0.081). Out of the six domains of FSD, multivariate analyses revealed that there was a significant reduction of 69% in sexual desire disorder (95% CI:0.110, 0.855), P=0.022 for those on agomelatine compared to escitalopram. Controlling for drug dosage and depression severity (as measured using Montgomery-Asberg Depression Rating Scale), the odds for patients on agomelatine developing sexual desire disorder was 0.267 (95% CI:0.091, 0.783), P=0.016. Conclusion: There was no significant difference in FSD risk between patients on agomelatine and those on escitalopram. Patients on agomelatine were however less likely to develop sexual desire disorder, which demonstrates a slightly better sexual acceptability profile of agomelatine in women in this respect compared to escitalopram.

Sexual Dysfunction Among Egyptian Idiopathic Parkinson’s Disease Patients

2021 ◽  
pp. 089198872110638
Author(s):  
Ahmed M. Elshamy ◽  
Ehab S. Mohamed ◽  
Ayman M. Al-Malt ◽  
Osama A. Ragab
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sexual Dysfunction ◽  
Rating Scale ◽  
Sexual Experience ◽  
Motor Symptom ◽  
Control Group ◽  
Idiopathic Parkinson’S Disease ◽  
Idiopathic Parkinson's Disease ◽  
And Gender

Background One of the non-motor features of idiopathic Parkinson’s disease (IPD) is sexual dysfunction (SD) which is under-recognized and, consequently, undertreated. This study aimed to evaluate SD in patients with IPD. Patients and methods The study was conducted on 67 IPD patients; 30 healthy subjects with age and gender matching with the patients served as the control group. All participants were subjected to sexual function assessment using the Arabic version of Arizona Sexual Experience Scale (ASEX), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI), while the severity of IPD was assessed using the modified Hoehn and Yahr scoring scale and MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Results There were no statistically significant differences between patients with IPD and the control group regarding MMSE, hypertension, diabetes mellitus, or dyslipidemia. However, BDI scores were significantly higher in patients with IPD. The rate of SD among our patients was 64% compared to 30% in the control group. The total score and subscales of ASEX were significantly higher in IPD patients than in controls. SD showed a significant correlation with the severity of the IPD irrespective of other variables, including patient age, sex, disease duration, hypertension, diabetes, dyslipidemia, smoking, and dose of L-dopa. Conclusion SD is a commonly underrated feature in patients with IPD; it should be investigated carefully as it is an important non-motor symptom that correlates with disease severity.

Bremelanotide and flibanserin for low sexual desire in women: the fallacy of regulatory precedent

2021 ◽  
pp. dtb-2021-000020
Author(s):  
Barbara Mintzes ◽  
Leonore Tiefer ◽  
Lisa Cosgrove
Keyword(s):  
Sexual Desire ◽  
Expert Testimony ◽  
Conflicts Of Interest ◽  
Sexual Experience ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Hypoactive Sexual Desire Disorder ◽  
Low Sexual Desire ◽  
The Us ◽  
Regulatory Decisions

The US Food and Drug Administration (FDA) has approved two drugs for ‘hypoactive sexual desire disorder’ in women, flibanserin (Addyi) in 2015 and bremelanotide (Vyleesi) in 2019. In this paper we examine the outcome measures and clinical trial data upon which regulatory approval was based. In clinical trials, flibanserin led to an average of only one additional enjoyable sexual experience every two months, bremelanotide to none. Trials for both drugs feature shifts in primary outcomes and a contested indication. A politicised industry-sponsored advocacy campaign and conflicted patient and expert testimony likely influenced flibanserin’s approval at its third attempt. Bremelanotide, with even weaker efficacy, capitalised on the regulatory precedent set by the approval of flibanserin. Reconsideration of regulatory decisions to approve these drugs is in order, as well as a broader examination of how future regulatory decisions can better address conflicts of interest and clinically meaningful benefit.

scholarly journals Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment

2019 ◽  
Author(s):  
J Don Richardson ◽  
Felicia Ketcheson ◽  
Lisa King ◽  
Callista A Forchuk ◽  
Renée Hunt ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Desire ◽  
Ptsd Symptom ◽  
Armed Forces ◽  
Symptom Clusters ◽  
Treatment Seeking ◽  
Regression Analyses ◽  
Medication Usage ◽  
Canadian Armed Forces ◽  
Male Treatment

Abstract Introduction There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage. Materials and Methods Participants included 543 male treatment-seeking veterans and Canadian Armed Forces (CAF) personnel (aged <65 years), referred for treatment between September 2006 and September 2014. Each participant completed self-report measures of demographic variables, depressive symptom severity, chronic pain, alcohol misuse, and psychotropic medication usage as part of a standard clinical intake protocol. Hierarchical ordinal logistic regression analyses were used to determine the incremental contribution of PTSD symptom clusters on sexual dysfunction. Results Nearly three-quarters (71.5%) of participants reported a lack of sexual desire or pleasure and 40.0% reported pain or problems during intercourse. Regression analyses suggested that avoidant/numbing symptoms were the only symptoms to be independently associated with lacking sexual desire or pleasure (AOR = 1.10; 95% CI 1.05–1.15). None of the PTSD symptom clusters were independently associated with pain or problems during intercourse. Conclusions Sexual dysfunction is prevalent among male treatment-seeking CAF personnel and veterans. Results suggest that PTSD symptoms are differentially associated with sexual desire or pleasure concerns. Assessing sexual function among CAF personnel and veterans seeking treatment for PTSD is critical in order to treat both conditions and improve overall functioning.

scholarly journals Sexual Dysfunction in Women with Depressive Disorder: A Prospective, Hospital Based Study

2019 ◽  
Vol 1 (2) ◽  
pp. 129-139
Author(s):  
Swaleha Mujawar ◽  
Suprakash Chaudhury ◽  
Daniel Saldanha
Keyword(s):  
Sexual Dysfunction ◽  
Depressive Disorder ◽  
Sexual Functioning ◽  
Rating Scale ◽  
Sexual Experience ◽  
Normal Subjects ◽  
Response To Treatment ◽  
Control Group ◽  
Recurrent Depression ◽  
Significant Difference

Background: Depression causes emotional and physical disturbances which impacts biological functions such as sleep, appetite, libido, and disinterest in sexual function. Since discussing sexual problems is considered a taboo, there is limited data available concerning the prevalence of sexual dysfunction in women with depression and its response to treatment. Aim: To assess the prevalence of sexual dysfunction in females with depressive disorder and the effects of treatment. Material and Methods: A total of 53 females with recurrent depression and age and sex matched normal control group were included in the study with their informed consent. All the subjects were assessed with the Hamilton Rating Scale for Depression (HAM-D), Arizona sexual experience scale (ASEX), and female sexual functioning index (FSFI), which were re-administered after 6 weeks of treatment. Results: There was a significant difference in the HAM-D, ASEX, and FSFI scores between index and control groups at baseline. There was a significant correlation between the scores of HAM-D, ASEX, and FSFI before treatment. The correlation between the HAM-D and ASEX scores after treatment was not significant. A significant correlation was found between the HAM-D scores and the scores of arousal, lubrication, orgasm, satisfaction, pain, total domains of FSFI after treatment. No correlation was found between the HAM-D scores and desire domain score of FSFI after treatment. Conclusion: Women with depression have a high prevalence of sexual dysfunction. A highly significant improvement in depression and sexual functioning was observed at the end of 6 weeks of antidepressant therapy. Despite the improvement in sexual dysfunctions, the individual domains of sexual functions were not comparable to the normal subjects at the end of 6 weeks suggesting the need for longer treatment.

scholarly journals Insights into the Vaginismus Treatment by Cognitive Behavioral Therapies: Correlation with Sexual Dysfunction Identified in Male Spouses of the Patients

2021 ◽  
Author(s):  
Süleyman Eserdag ◽  
Didem Kurban ◽  
Emrah Yakut ◽  
Prabhu Chandra Mishra
Keyword(s):  
Erectile Dysfunction ◽  
Sexual Dysfunction ◽  
Sexual Desire ◽  
Couple Therapy ◽  
Premature Ejaculation ◽  
Sexual Experience ◽  
Educational Status ◽  
Sexual Problems ◽  
Cognitive Behavioral ◽  
Female Patients

Objective: To examine retrospectively sexual dysfunction in the male spouses of 425 female patients who had presented to our clinic and were diagnosed with primary vaginismus. Materials and methods: Seven questions related to age, profession, educational status, number of marriages, personality structure, sexual experience, and sexual dysfunction history were directed to the spouses of the 425 female patients presenting to our clinic for vaginismus treatment between 2015 and 2018. Men reporting sexual dysfunction were evaluated by a urologist, and the necessary treatment was initiated. Cognitive-behavioral couple therapy was started for all patients. Results: Of the 425 men, 73.9% stated that they did not have any sexual problems. Of the 111 men (26.1%) stated that they had one or more sexual problems, 77 (18.1%) were diagnosed with premature ejaculation, 25 (5.8%) erectile dysfunction, 36 (8.4%) hypoactive sexual desire, and one (0.2%) had delayed ejaculation. Premature ejaculation and erectile dysfunction were identified in nine patients, premature ejaculation and hypoactive sexual desire in seven, and erectile dysfunction and hypoactive sexual desire in four patients. There was an increased rate of sexual dysfunction in men in cases where the duration of marriage without coitus was longer than three years. Conclusion: In the treatment of vaginismus, male sexual dysfunction should not be ignored. Spouses should be questioned for sexual dysfunction and included in the treatment process.

scholarly journals S234. DEPRESSION AND SEXUAL FUNCTIONING: TWO NEGLECTED AND PREVALENT DOMAINS IN PEOPLE WITH SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S127-S128
Author(s):  
Clara Lapa ◽  
Dayane Martins ◽  
Maria Julia Brito ◽  
Ramiro Reckziegel ◽  
Mathias Hasse-Sousa ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Medication Adherence ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Sexual Experience ◽  
Depression Symptoms ◽  
Chronic Patients

Abstract Background Sexual function is highly neglected in individuals with schizophrenia (SZ). Clinicians usually underestimate the rates of sexual dysfunctions in these patients, and this group does not spontaneously complain about it. Sexual dysfunction in this population could reach up to 80% and its known to affect all domains of sexual function. Moreover, it may be linked to stigma and discrimination factors. Medication side effects on sexuality concern more than any other side effects, and it is known to be a major cause of poor quality of life and non-adherence to medication. Furthermore, the relationship between sexual dysfunction and other psychiatric symptoms in SZ is still unclear. Our aim was to describe the sexual dysfunction in chronic patients with SZ and its relation to negative, positive and depressive symptoms. Methods A convenience and exploratory sample of 57 patients (age 43.75±10.38, 69% men, 86,2% single) were recruited from an university outpatient schizophrenia clinic, in Porto Alegre – Brazil. Participants were assessed using Arizona Sexual Experience Scale (ASEX), Medication Adherence Rating Scale (MARS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Inventory and demographic information. Sexual dysfunction was considered following the ASEX scoring criteria. Results Sexual dysfunction was present in 51,8% of the patients, assessed by ASEX. Women showed increased sexual dysfunction than men (χ2=22,727, p &lt; .001). There were no differences between patients that reported sexual dysfunction and the ones who did not regarding age, duration of illness and medication adherence assessed by MARS (p &gt; .05). Additionally, there were no differences between groups on positive and negative symptoms assessed by PANSS. Interestingly, patients with sexual dysfunction had increased depressive symptoms compared to patients with a good perceived sexual function (t(54) = -3.326, p = .002). Calgary total scores were positively correlated with ASEX total scores (r = .369, p = .005). Nevertheless, we did not find significant correlations between ASEX total scores and other scales. Scores found on MARS (8.07±1.5) suggest that this sample is highly adherent to prescribed treatment. Discussion This is an exploratory and preliminary study that shows and reinforces the idea that sexual dysfunction is importantly prevalent and remains as a neglected issue in individuals with schizophrenia, as are the depressive symptoms. We showed that there is an association between these two domains, which might indicate a need for change of perspective for the pharmacological and psychosocial approaches currently used. In addition to the dopaminergic blockage by antipsychotics that lead to reduction in positive symptoms, we believe there is a need to look for depression symptoms to access, prevent and treat sexual dysfunction. Inattention to this event may result in abrupt treatment discontinuation and relapse. Curiously, the fact that we did not find any correlations between sexual evaluations and PANSS scores would suggest that sexual dysfunction in chronic patients could differ from others stages of the disease. The size of our sample and the fact that we did not access hormones and prolactin levels are important limitations of this study. However this is an exploratory study that provided clues on the subject, allowing to address further investigation taking into account the limitations.

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