title: Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review.
abstract: There is limited evidence for the management of sexual dysfunction and/or hyperprolactinemia resulting from use of antipsychotics in patients with schizophrenia and spectrum. The aim of this study was to review and describe the strategies for the treatment of antipsychotic-induced sexual dysfunctions and/or hyperprolactinemia. The research was carried out through Medline/PubMed, Cochrane, Lilacs, Embase, and PsycINFO, and it included open labels or randomized clinical trials. The authors found 31 studies: 25 open-label noncontrolled studies and 6 randomized controlled clinical trials. The randomized, double-blind controlled studies that were conducted with adjunctive treatment that showed improvement of sexual dysfunction and/or decrease of prolactin levels were sildenafil and aripiprazole. The medication selegiline and cyproheptadine did not improve sexual function. The switch to quetiapine was demonstrated in 2 randomized controlled studies: 1 showed improvement in the primary outcome and the other did not. This reviewed data have suggested that further well-designed randomized controlled trials are needed to provide evidence for the effects of different strategies to manage sexual dysfunction and/or hyperprolactinaemia resulting from antipsychotics. These trials are necessary in order to have a better compliance and reduce the distress among patients with schizophrenia.
authors.affiliation: Department of Psychiatry, Universidade Estadual de Londrina, Paraná, Brazil.
authors.forename: Luciana Vargas Alves
authors.initials: LV
authors.lastname: Nunes
authors.forename: Hugo Cogo
authors.initials: HC
authors.lastname: Moreira
authors.forename: Denise
authors.initials: D
authors.lastname: Razzouk
authors.forename: Sandra Odebrecht Vargas
authors.initials: SO
authors.lastname: Nunes
authors.forename: Jair De Jesus
authors.initials: Jde J
authors.lastname: Mari
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D011687:Purines / Q000008:administration & dosage; D015363:Quinolones / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D011687:Purines; D015363:Quinolones; D013450:Sulfones; D014665:Vasodilator Agents; D000068180:Aripiprazole; D000068677:Sildenafil Citrate