The present study examined sexual functioning among first-time treated schizophrenia patients at the time that they initiated antipsychotic treatment, and again 3 and 6 months later. These first-time treated patients comprise a subgroup of 570 schizophrenia patients who were part of a cohort of 7,655 patients enrolled in the Intercontinental Schizophrenia Outpatient-Health Outcomes observational study (IC-SOHO). As part of a brief clinical assessment conducted at entry to the study, and after 3 and 6 months of antipsychotic medication, patients were asked to rate their sexual functioning, and the investigator was asked to rate the extent to which the patient had neuroleptic-related loss of libido and sexual dysfunction. After being treated, patients treated with olanzapine showed the lowest prevalence of neuroleptic-induced sexual difficulties. At 3 months, there were significant differences between the treatment groups on neuroleptic-related loss of libido, neuroleptic-related sexual dysfunction and change in patient-rated sexual dysfunction. At 6 months, the difference between the groups on neuroleptic-related loss of libido was statistically significant. There were no significant differences between males and females. Many recent onset patients appear to suffer from problems of sexual functioning. Olanzapine may offer an advantage in this area.
"A 6-month observational study examining sexual functioning among first-time treated schizophrenia patients showed that the loss of libido was significantly less common in the olanzapine group (17.8% at 6 months) as compared to the risperidone (35.5% at 6 months) and haloperidole groups (38.7% at 6 months).24 "
[Show abstract][Hide abstract] ABSTRACT: Sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect, resulting in a negative effect on treatment compliance. It is known that hyperprolactinemia is a major cause of sexual dysfunction. Based on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics, while olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole are classed as prolactin-sparing drugs. Risperidone and the other typical antipsychotics are associated with a high rate of sexual dysfunction as compared to olanzapine, clozapine, quetiapine, and aripiprazole. With regard to treatment in patients suffering from sexual dysfunction, sildenafil was associated with significantly more erections sufficient for penetration as compared to a placebo. Subsequent studies are needed in order to provide physicians with a better understanding of this problem, thereby leading toward efficacious and safe solutions.
"Bearing in mind the limitations associated with its design, data from the SOHO study, a large observational study funded by Lilly, indicates an advantage to both olanzapine and quetiapine, compared with risperidone and FGA drugs, across areas of sexual dysfunction   . A previous European study concluded that there were no real benefits of any of the SGAs over FGA treatment, apart from that seen with quetiapine in short-term trials . "
[Show abstract][Hide abstract] ABSTRACT: The impact of antipsychotic drug treatment on sexual function was investigated during a randomised trial comparing first generation antipsychotics (FGAs) to (nonclozapine) second generation antipsychotics (SGAs). Sexual function and quality of life were (rater-blind) assessed in 42 patients with DSM-IV schizophrenia (aged 18-65) using the self-report version of the Derogatis Interview for Sexual Function (DISF-SR) and the Heinrichs Quality of Life Scale (QLS), prior to, and 12 weeks following, a change in medication from an FGA drug to either an FGA or SGA drug. SGAs significantly improved sexual function compared to FGAs. Change in sexual function was associated with change in quality of life. Where impaired sexual functioning is a distressing adverse effect of treatment with an FGA agent, consideration should be given to switching to an SGA.
"This is somewhat different from satisfaction with life in general, where psychopathology has been found to contribute to the variation (Barry & Zissi, 1997; Eklund & Bäckström, 2005; Eklund, Bäckström et al., 2003), as have side-effects of and satisfaction with pharmacological treatment (Awad, Voruganti & Heslegrave, 1997; Eklund & Bäckström, 2005). However, our fi ndings agree with research on patient-rated sexual dysfunction, showing no association with type of antipsychotic medication (Bitter et al. 2005; Macdonald et al., 2003). "
[Show abstract][Hide abstract] ABSTRACT: It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness.
This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations.
Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables.
No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation.
Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.
International Journal of Social Psychiatry 08/2009; 56(4):336-47. DOI:10.1177/0020764008101635 · 1.15 Impact Factor
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