Antipsychotics and Sexual Dysfunction

Suggestions for Treating Sexual Dysfunction

It is not possible for your healthcare provider to know beforehand whether you will develop any sexual side effects from antipsychotic use. Also, it can sometimes be difficult to know whether sexual side effects are caused by antipsychotic use or another condition. Many of the mental health problems treated with antipsychotics can lead to problems with sexual well-being.
Unfortunately, there are very few studies that have looked at the best way to treat antipsychotic-related sexual side effects. Therefore, the best treatment approach is not known. Some of the strategies healthcare providers may recommend include the following:
  • Reducing the antipsychotic dose
  • Switching to another antipsychotic
  • Adding another medication.
Sexual side effects of antipsychotics may be more likely to occur at higher doses. Therefore, reducing the antipsychotic dose may help alleviate some of these side effects. However, a lower dose is only an option in people who are stable, not currently having symptoms of their illness, and who may do okay on a lower dose. A lower dose may not be a good choice if you are currently having symptoms of your illness, or had symptoms at a lower dose in the past.
Because some antipsychotics are more likely to cause sexual side effects than others, switching to another antipsychotic may help reduce troublesome sexual side effects. However, this approach is only an option in people who may do well on another antipsychotic. If you have been stable on your current antipsychotic, your healthcare provider may not want to switch you -- another antipsychotic may not work as well for you.
If your healthcare provider chooses to switch you to a new medication, you will need to be closely monitored during and in the period after the switch to make sure the new medication is right for you.
Certain medications called phosphodiesterase (PDE) inhibitors may be beneficial in treating antipsychotic-related erectile dysfunction, or impotence. In clinical studies, sildenafil citrate (Viagra®) was shown to improve impotence in people taking antipsychotics. However, sildenafil may not be a good choice for sexual side effects other than impotence (such as decreased sex drive). This is because sexual excitement is necessary for sildenafil (and other PDE inhibitors) to work.
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