Sexual dysfunction often goes unrecognized in adult schizophrenic patients, but reportedly affects up to 60% of these individuals. This is twice the incidence in the general male population. Antipsychotic medications, including olanzapine, risperidone, quetiapine and haloperidol, can contribute to male sexual dysfunction in schizophrenic patients.
Dr. Mark Olfson and associates from the New York State Psychiatric Institute and South Beach Psychiatric Center in New York, Otsuka Pharmaceutical, Rockville, Md. and Bristol-Meyers Squibb Company, Wallingford, Conn. examined the prevalence and clinical correlates of sexual dysfunction in schizophrenia outpatients treated with the above 4 medications. Their findings are reported in the March 2005 issue of the Journal of Clinical Psychiatry.
They conducted a cross-sectional study of sexual function of male outpatients with schizophrenia from 3 state psychiatric hospitals. They studied patients aged 18-70 years who met diagnostic criteria for either schizophrenia or schizoaffective disorder and were undergoing treatment with antipsychotic monotherapy using olanzapine, risperidone, quetiapine, or haloperidol.
A structured assessment was administered. It included clinical parameters and antipsychotic drug dosages. The Changes in Sexual Functioning Questionnaire, Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia were administered.
Criteria for current sexual dysfunction were met by 45.3%. Sexual dysfunction in patients 55 years and older was 61.5%, as compared to 41.6% in younger patients. Most patients were never married, were unemployed, had not attended college and were Medicaid beneficiaries.
Those with sexual dysfunction reported significantly poorer general quality of life and less satisfaction with the amount of enjoyment in their lives. These patients were 3 times less likely to have a romantic partner, or for those with a partner, to share personal thoughts with them.
The decline in sexual pleasure was attributed by patients to aging in 35%, to their medication in 26%, to a change in their relationship in 14%, a change in their situation in 13% or their illness in 12%.
Difficulty maintaining an erection was reported by half of the study patients, and this was attributed to their medication in 49% as compared to situational problems with their partners in 30%.
Overall, 36% of patients specifically indicated that they thought their antipsychotic medication was the cause of 1 or more of their sexual problems. These data document the incidence of and increase the understanding of sexual dysfunction in the population of schizophrenic patients on specific medications.
###
Written by Christopher P. Evans, MD, a Contributing Editor with UroToday
J Clin Psychiatry 2005;66:331-338
urotoday.com