Erectile dysfunction and antipsychotics

2011 ◽  
Vol 26 (S2) ◽  
pp. 1543-1543
Author(s):  
F. Fifani ◽  
Y. Otheman ◽  
M. Outarahout ◽  
A. Ouanass

Sexual side effects associated with antipsychotic medications constitute an understudied set of side effects that diminish a patient's quality of life, and lead to noncompliance with treatment. Male patients frequently report disturbances in erectile and ejaculatory functioning, as well as changes in libido. The capacity to trigger sexual dysfunction differs from one antipsychotic to another. Clinicians prescribing antipsychotic medications should be familiar with the classification, evaluation and treatment of these side effects. The purpose of this study is to assess the occurrence of erectile dysfunction for 5 classes of antipsychotics (Haloperidol, Risperidone, Olanzapine, Amisulpride and Fluphenazine decanoate) in a population of 120 patients, using the International Index of Erectile Dysfunction (IIEF 5).

2019 ◽  
Author(s):  
Abolfazl Ghoreishi ◽  
Lila Dashtaki ◽  
Bahareh Hajisalimi

Sexual dysfunction is a common complication among male patients with chronic kidney disease. Common disturbances include erectile dysfunction, decreased libido, and infertility. Sexual dysfunction is a multifactorial problem, and the treatment options are limited, it associated with lower quality of life scores in patients. Chronic kidney disease also has a critically impairing effect on the quality of life. To investigate the efficacy of bupropion on sexual dysfunction and quality of life in men with chronic kidney disease, a single-blind placebo-controlled trial was conducted. A total of 40 male patients with chronic kidney disease suffering from erectile dysfunction (Mean age 41/25±8/8) were randomly assigned to receive 10 weeks of treatment with either bupropion or placebo. Sexual function and quality of life were assessed by IIEF5 and WHOQOL-BREF questionnaires, respectively. Baseline demographic and clinical features were similar in both groups. The results showed a significant difference between the intervention and control groups in sexual function (P=0/005) and total quality of life (P=0/001); also the difference was significant in physical health (P=0/012), psychological health (P<0/001) and social relationship (P<0/001) domains. Our findings suggest that Bupropion is effective and safe for treating sexual dysfunction in men with chronic kidney disease and also could positively affect the quality of life among the patients. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):320-327.


2020 ◽  
Vol 73 (10) ◽  
pp. 2277-2281
Author(s):  
Kamila Fuczyło ◽  
Magdalena Piegza ◽  
Robert Pudlo

The aim: To systematize and bring the reader closer to knowledge about the occurrence of sexual disorders in people after heart transplantation based on available bibliography. Material and methods: A review of the literature on this topic from the last 30 years made with using the PubMed database, using a total of 17 articles. Conclusions: The incidence of sexual dysfunction (SD) is higher in heart recipients than in the general population and erectile dysfunction is the most common. When the symptoms of dysfunction occur before the transplant – they do not improve, rather they get worse, which reduces the improvement in the quality of life of these patients compared to patients without sexual dysfunction. Improvement in quality of life is observed in patients with SD after heart transplantation, but not as pronounced as in subjects without sexual dysfunction. Some patients notice an increase in libido, with the genital response being insufficient or completely disappearing, which results in a decrease in the quality of relationships between partners and a deterioration in the quality of life. The cause of SD in heart recipients is unclear, but it is associated with the type of immunosuppression used, the level of sexual activity and the state of health of patients prior to transplantation. Nowadays patients after ortotrophic heart transplant live longer and their quality of life improves, but not in sexual terms. The articles concerned almost exclusively men, that is why the topic requires exploration in subsequent research.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3587-3587
Author(s):  
Laura Diane Porter ◽  
Ronit Yarden ◽  
Kim Lynn Newcomer ◽  
Negeen Fathi ◽  

3587 Background: Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. Young-onset colorectal cancer refers to individuals diagnosed under the age of 50. In recent years, the incidence has increased by 2.2% annually in individuals younger than 50 years and 1% in individuals 50-64, in contrast to a 3.3% decrease in adults 65 years and older. Young-onset (YO) CRC patients and survivors face unique clinical challenges with fertility and sexual dysfunctions, but this risk is not well quantified. There is limited data and public discussion on the long-term effects of colorectal cancer treatments on fertility and sexual dysfunction and the long-term impact on the quality of life. Methods: To explore the unique challenges and unmet needs of the young-adult patient population, a cross-sectional study was conducted. Colorectal cancer patients and survivors (N = 884) diagnosed between the ages of 20 to 50 years old (median age 42 ± 7.0) completed an online questionnaire based on established instruments EORTC-QOL-30, EORTC-CR-29, and EORTC-SHC-22. Results: Thirty-one percent of respondents stated that a medical professional spoke to them about fertility preservation at the time of diagnosis and during treatment. Only 31% were referred to a reproductive endocrinologist, even though 37% of women and 16% of men reported that treatment left them infertile or sterile. Among survey respondents, 12% of women had an egg retrieval procedure, and 36% of men had their sperm preserved prior to the start of treatment. Fifty-three percent of women reported treatment led to premature menopause. Sixty-five percent of respondents suffer from some level of sexual dysfunction due to treatment. In patients who received radiation therapy, women were 12% less likely than men to have discussed sexual side effects with the provider before treatment. Patients who have an ostomy reported more severe sexual dysfunction (17.8%). Rectal cancer patients were 2.5 times more likely than those with colon cancer to report severe dysfunction after their treatment. More than 25% of the respondents said they would have considered alternative treatment if they would have known the risks of sexual dysfunction. Conclusions: Our survey demonstrates inadequate communications between patients and providers about the irreversible fertility and sexual effects of colorectal cancer treatments. Younger patients and survivors face unique long-term challenges and require further information about fertility preservation options and emotional support regarding their sexuality post-treatment. Other studies are needed to assess the physical and psychological side effects endured by young-onset CRC patients and survivors.


ESC CardioMed ◽  
2018 ◽  
pp. 1030-1035
Author(s):  
Mike Kirby ◽  
Jonny Coxon

It should not be presumed that male patients with cardiovascular disease are less sexually active than others, but they are more likely to have erectile dysfunction. It is therefore crucial to consider the impact on sexual function of medications commonly used to treat cardiovascular disease, because negative effects on erectile dysfunction can lead to problems with compliance and quality of life. Cardiovascular implications of phosphodiesterase type 5 inhibitors used to treat erectile dysfunction should be borne in mind. Effective treatment of the cardiac condition should always take priority.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Pedro do Valle Teichman ◽  
Gabrielle Zanotto de Oliveira ◽  
Samile Sallaberry Echeverria Silveira ◽  
Carlos Alberto Angarita Jaime ◽  
Mariana Lopes De Castro ◽  
...  

Abstract Background and Aims Hyperprolactinemia is a hormonal disorder associated with many diseases, including chronic kidney disease (CKD). Some studies have shown that serum prolactin (PRL) levels increase as CKD progresses, due to decreased renal clearance and increased production. This prolactin retention leads to inhibition of gonadotropic hormone production, and testosterone deficiency in male patients with CKD. Thus, this study aimed to evaluate PRL levels in male patients with different stages of CKD and its association with clinical and laboratory characteristics, strength, sexual dysfunction, and quality of life. Method This is a transversal study conducted in a tertiary hospital in southern Brazil. Patients with CKD stage IV and V were included and divided into three groups: 1) stage IV; 2) non-dialysis-dependent stage V and; 3) dialysis-dependent stage V (VD). Patients with prescribed hormone therapy were excluded. PRL, creatinine, testosterone, estradiol, albumin, SHBG, LH, and FSH levels were measured. Free testosterone was estimated by the Vermeulen equation. Patients were also evaluated for strength and musculoskeletal function through the “handgrip strength” test. For evaluation of the quality of life and sexual dysfunction, validated questionnaires were applied: AMS (Aging Male's Symptoms Scale), ADAM (Androgen Deficiency in the Aging Male) and SF-36 Health. Results In this study, 164 patients were included (IV=75; V=41; VD=48). The mean age was 64 [55-71] years and BMI 26,9 [23,3-30,04] kg/m2. The dialysis-dependent group had higher prevalence of hyperprolactinemia (22,6% vs. 49% vs. 66%, p&lt;0,001), higher PRL (13,4 vs. 19,43 vs. 26,13, p&lt;0,001) and estradiol (25,6 vs. 24,4 vs. 30,5, p=0,041). PRL levels were positive correlated with CKD stage (rs=0,482, p&lt;0,001) and creatinine (rs=0,467, p&lt;0,001) and negative correlated with testosterone (rs=-0,286, p&lt;0,001) and free testosterone levels (rs=-0,307, p&lt;0,001). There was no difference in PRL levels between hemodialysis and peritoneal dialysis (p=1,000). Analyzes related to the association of PRL levels with strength, quality of life, and sexual dysfunction are still being analyzed. Conclusion Hyperprolactinemia is associated with the severity of CKD, with a higher prevalence in dialysis patients. The relation of PRL levels with strength, quality of life, and sexual dysfunction are being evaluated.


2016 ◽  
Vol 33 (S1) ◽  
pp. S591-S591
Author(s):  
O.W. Muquebil Ali Al Shaban Rodriguez ◽  
S. Ocio León ◽  
M. Gómez Simón ◽  
M.J. Hernández González ◽  
E. Álvarez de Morales Gómez-Moreno ◽  
...  

IntroductionThe side effects of the various antidepressant drugs on the sexual field (with very few exceptions) are well known, and they affect the quality of life in important manners. The incidence rate, communicated spontaneously by the patient, has been estimated around 10–15%, and can reach amounts of 50–60% with SSRIs when studied specifically. It has been suggested that these effects compromise treatment adherence.ObjectivesTo estimate the incidence and intensity of the side effects on the sexual field with different antidepressants, as well as its relationship with treatment adherence.MethodologyTransversal study on 50 patients assisted in medical consultation. Collection of data in office (October 2014–October 2015).Administration of survey PRSexDQ-SALSEX. In order to research the relationship with treatment adherence, one question surveyed the patient whether he/she had thought about finishing treatment for this reason.ResultsTwenty-nine patients (58% of the sample) presented some degree of sexual dysfunction. Five individuals (17.2%) communicated it spontaneously. Nine individuals (31%) responded that they did not accept positively the changes in their sexual field, and they had thought about withdrawing treatment for this reason. They were given the test of self-compliance statement (Haynes-Sackett), with a result of four non-compliant (44.4%). The most frequently involved drugs were fluoxetine (n = 5, 10% of the sample total) and paroxetine (n = 4, 8%).ConclusionsThe high impact of sexual side effects with a low rate of spontaneous communication coincides with previous existent studies.Limitation when estimating adhesion due to methodological difficulties in the design of the study. However, high impression by using the selected method of determination.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2014 ◽  
Vol 29 (S3) ◽  
pp. 672-673
Author(s):  
O. Andlauer ◽  
M. Rojnic-Kuzman

Antipsychotic medications are used to treat a significant number of psychiatric disorders, such as schizophrenia or bipolar disorder, which have a significant impact on overall disability in Europe. Although these drugs have documented efficacy, they are also associated with side-effects such as drowsiness, weight gain, type 2 diabetes, or extrapyramidal symptoms [1]. These contribute to increasing overall morbidity and mortality [2], reduced quality of life, and can push patients to stop their medications. This often leads to relapse, and the need for a new hospital admission, which is detrimental to the patient, and create extra costs for the society. However, the monitoring of side-effects is rarely carried out in a standardized way in daily clinical practice. Smartphones are an acceptable and easy to use tool available to patients with schizophrenia [3]. The aim of the mPIVAS (mHealth psychoeducational intervention versus antipsychotic-induced side effects) project is to develop an effective and innovative smartphone application that can be used by psychiatrists and patients in order to monitor medications’ side-effects. The European Psychiatric Association (EPA) is involved in this project with the objective to develop this application in 6 languages. Part of the project includes training European early careers psychiatrists to the use Psylog and helping them to spread information about this new project in their own country, by organising local and national cascade courses. We expect an improvement in psychiatric care in all involved institutions through the education of employees, a better implication of patients in their disease, and an improved monitoring of antipsychotic side-effects.


2011 ◽  
Vol 4 (6) ◽  
pp. 375-383 ◽  
Author(s):  
Gila Bronner ◽  
David B. Vodušek

Nonmotor symptoms, among them sexual dysfunction, are common and underrecognized in patients with Parkinson disease; they play a major role in the deterioration of quality of life of patients and their partners. Loss of desire and dissatisfaction with their sexual life is encountered in both genders. Hypersexuality (HS), erectile dysfunction and problems with ejaculation are found in male patients, and loss of lubrication and involuntary urination during sex are found in female patients. Tremor, hypomimia, muscle rigidity, bradykinesia, ‘clumsiness’ in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function. Optimal dopaminergic treatment should facilitate sexual encounters of the couple. Appropriate counselling diminishes some of the problems (reluctance to engage in sex, problems with ejaculation, lubrication and urinary incontinence). Treatment of erectile dysfunction with sildenafil and apomorphine is evidence based. HS or compulsive sexual behaviour are side effects of dopaminergic therapy, particularly by dopaminergic agonists, and should be treated primarily by diminishing their dose. Neurologists should actively investigate sexual dysfunction in their Parkinsonian patients and offer treatment, optimally within a multidisciplinary team, where a dedicated professional would deal with sexual counselling.


2016 ◽  
Vol 33 (S1) ◽  
pp. S54-S55
Author(s):  
Y. Cohen

From the patients’ point of view, valued-based mental healthcare is mental healthcare based on a holistic vision of care, according to which patients are actively involved in their treatment to achieve the best possible outcomes. They are invited to collaborate with both mental health care providers such as psychiatrists and primary caregivers to determine what types of treatment are the most effective.GAMIAN-Europe believes that the best package of care includes the following four elements:– medication – antipsychotic medication is consensually regarded as first-line treatment for people with mental health problems;– psychotherapy/counselling – although antipsychotic medications are the mainstay of treatment for mental health problems, pharmacotherapy alone produces only limited improvement in negative symptoms, cognitive function, social functioning and quality of life. Additionally, many patients continue to suffer from persistent positive symptoms and relapses, particularly when they fail to adhere to prescribed medications. These situations emphasize the need for multimodal care, which includes psychosocial therapies as adjuncts to antipsychotic medications in order to alleviate symptoms and to improve social functioning and quality of life;– psycho-education – the more a patient learns about his/her condition the better placed he/she will be to take control of it. Psycho-education embodies this principle by using a clearly-defined therapeutic programme, in which a trained therapist delivers targeted information designed to reduce both the frequency and the severity of symptoms. Psycho-education increases patients’ knowledge and understanding of their illness and treatment options and helps them cope more effectively. Many people find that they benefit not only from the information they receive during psycho-education, but also from the learning process itself. There are several different ways in which psycho-education can be delivered, including one-to-one sessions with a therapist, sessions aimed specifically at carers and family members, group sessions attended by several people coping with mental illness and mixed group sessions attended by people with mental illnesses and family members;– self-help – self-help groups offer patients a voice and an audience with the time and inclination to listen to patients’ concerns and reassure them and ease their anxiety. For example, a self-help group may be able to quell anxiety regarding side effects, to reassure the patient, from first-hand experience, that these side effects are transient, normal and non-threatening and will diminish over time. The real experts on living with a mental disorder are those who are already doing so. Therefore, most support groups are full of people who can share information about how they have managed to cope with their illnesses.Disclosure of interestThe author has not supplied his declaration of competing interest.


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