title: Sexual dysfunction and hormonal changes in first episode psychosis patients on olanzapine or risperidone.
abstract: Atypical antipsychotics interfere with central and peripheral neurotransmitter systems and with hormonal production. In this study we compared the effect of olanzapine and risperidone on hormonal state and sexual function (by using the Questionnaire for Sexual Dysfunction, QSD) in 40 patients with a first episode psychosis. Results were compared to those of 34 healthy controls. Patients using risperidone had significant higher prolactin levels than patients using olanzapine. Patients using olanzapine had significantly higher 17beta-estradiol levels than patients using risperidone. Overall satisfaction with sexuality was less in patients compared to controls, but not different between patients using olanzapine and those using risperidone. Problems with sexual arousal were significantly higher in patients using olanzapine compared to patients using risperidone. A significantly higher frequency of problems with ejaculation and problems with insensibility of genitals were found in patients compared to healthy controls. We found no relation between medication, prolactin and 17beta-estradiol levels, frequency of sexual activity, overall satisfaction with sexuality and any of the 18 sexual dysfunctions we investigated. Our results suggests that sexual dysfunction in patients with first episode psychosis might occur despite normal prolactin levels. Also, sexual dysfunction is highly prevalent in healthy controls. Awareness should be raised of potential sexual problems in young adults.
authors.affiliation: Department of Psychiatry, AMC University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. m.vanbruggen@amcdemeren.nl
authors.forename: Marion
authors.initials: M
authors.lastname: van Bruggen
authors.forename: Thérèse
authors.initials: T
authors.lastname: van Amelsvoort
authors.forename: Luuk
authors.initials: L
authors.lastname: Wouters
authors.forename: Peter
authors.initials: P
authors.lastname: Dingemans
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
authors.forename: Don
authors.initials: D
authors.lastname: Linszen
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology; D001569:Benzodiazepines / Q000009:adverse effects* / Q000494:pharmacology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D011388:Prolactin / Q000097:blood*; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000009:adverse effects* / Q000494:pharmacology; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000378:metabolism*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D004958:Estradiol; D011388:Prolactin; D018967:Risperidone; D000077152:Olanzapine