title: Prolactin, subjective well-being and sexual dysfunction: an open label observational study comparing quetiapine with risperidone.
abstract: BACKGROUND
  Sexual dysfunction is a frequent side effect of antipsychotic treatment. Increased prolactin levels are believed to be responsible for this sexual impairment despite contradictory results.
  
  
  OBJECTIVE
  The primary objective of the present study was to examine the relationship between sexual dysfunction, subjective well-being and prolactin levels in patients with schizophrenia treated either with risperidone or quetiapine. The secondary objective was to explore the relationship between testosterone and the severity of positive and negative symptoms of schizophrenia in male patients.
  
  
  METHODS
  In a 4-week nonrandomized open label observational study, 102 inpatients with schizophrenia were recruited. Sexual functioning, subjective well-being and endocrinological parameters were assessed as well as psychopathological characteristics.
  
  
  METHODS
  Two self-rating questionnaires concerned with sexual functioning ("Essener Fragebogen zur Sexualität") and Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) were completed by the patients. Plasma levels of prolactin in male and female patients were measured. Furthermore, in male patients testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined. Positive and Negative Symptom Scale (PANSS) was applied.
  
  
  RESULTS
  After 4 weeks, patients treated with quetiapine reported less severe sexual impairment, as well as lower PANSS negative and general score compared with patients treated with risperidone. Additionally, emotional regulation as measured with the SWN was higher in patients treated with quetiapine. Risperidone was significantly associated with elevated prolactin levels. Prolactin levels were not correlated either with sexual dysfunction or PANSS. However, in the group of patients treated risperidone, sexual impairment was significantly associated with the SWN subscale emotional regulation.
  
  
  CONCLUSIONS
  Increased prolactin levels do not seem to be decisive for antipsychotic induced sexual dysfunction. Improvement of severity of illness and regaining the ability to regulate one's own emotion have positive influence on sexual functioning.
authors.affiliation: Department of Psychiatry, University of Bonn, Bonn, Germany. jens.westheide@ukb.uni-bonn.de
authors.forename: Jens
authors.initials: J
authors.lastname: Westheide
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cvetanovska
authors.forename: Carsten
authors.initials: C
authors.lastname: Albrecht
authors.forename: Niclaas
authors.initials: N
authors.lastname: Bliesener
authors.forename: Déirdre
authors.initials: D
authors.lastname: Cooper-Mahkorn
authors.forename: Cornelia
authors.initials: C
authors.lastname: Creutz
authors.forename: Wolfgang-Peter
authors.initials: WP
authors.lastname: Hornung
authors.forename: Dietrich
authors.initials: D
authors.lastname: Klingmüller
authors.forename: Matthias R
authors.initials: MR
authors.lastname: Lemke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Michaela
authors.initials: M
authors.lastname: Schubert
authors.forename: Birgitta
authors.initials: B
authors.lastname: Sträter
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Kühn
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects; D003987:Dibenzothiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000097:blood / Q000139:chemically induced / Q000523:psychology; D005260:Female; D006801:Humans; D007989:Libido / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009948:Orgasm / Q000187:drug effects; D011388:Prolactin / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012735:Sexual Dysfunction, Physiological / Q000097:blood / Q000139:chemically induced* / Q000523:psychology; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate; D013739:Testosterone; D011388:Prolactin; D018967:Risperidone