title: Change in sexual dysfunction with aripiprazole: a switching or add-on study.
abstract: Sexual dysfunction and raised prolactin are common adverse effects of many anti-psychotics. Aripiprazole is an atypical anti-psychotic associated with a reduction in prolactin level in anti-psychotic-induced hyperprolactinemia. Our hypothesis was that switching from another anti-psychotic to aripiprazole would be associated with a reduction in sexual dysfunction. An open label switch to aripiprazole was offered to 27 subjects with inadequate therapeutic response or intolerance to another anti-psychotic, who were followed up for 26 weeks. Serial clinical ratings included the Anti-psychotic Non-Neurological Side-Effects Rating Scale (ANNSERS), and the Sexual Functioning Questionnaire. Our primary analysis point was week 12. In both sexes, there was a significant reduction in prolactin by week 12 (P = 0.003), accompanied by a significant improvement in libido (P = 0.028). In males, both erectile and ejaculatory difficulties were also significantly reduced (P = 0.04 and P = 0.017, respectively). In females, menstrual dysfunction was also significantly reduced at week 12 (P = 0.04). By week 26, the changes in all of the above remained significant, and were accompanied by a significant increase in satisfaction in overall sexual functioning (P = 0.007), despite the fact that 54.5% of subjects at were also taking their original antipsychotic. There was also a significant decrease in the total ANNSERS score (P < 0.001) and a significant improvement in all other measures of psychopathology (PANSS, CGI-S/I, GAF-S/D, and QoL). We conclude that switching to aripiprazole or the addition of aripiprazole to another antipsychotic regime is associated with a reduction in sexual dysfunction.
authors.affiliation: COAST Team (Croydon Early Intervention in Psychosis Service), Westways Resource Centre, Croydon, UK.
authors.forename: Amna
authors.initials: A
authors.lastname: Mir
authors.forename: Kuppuswami
authors.initials: K
authors.lastname: Shivakumar
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Williamson
authors.forename: Victoria
authors.initials: V
authors.lastname: McAllister
authors.forename: Veronica
authors.initials: V
authors.lastname: O'Keane
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D004542:Ejaculation / Q000187:drug effects; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000523:psychology; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced; D007989:Libido / Q000187:drug effects; D008297:Male; D008599:Menstruation Disturbances / Q000139:chemically induced; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy; D015363:Quinolones / Q000009:adverse effects* / Q000627:therapeutic use; D012727:Sex Characteristics; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole