Purpose – The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing an assessment of sexual functioning. Third, the role of the pharmaceutical industry is explored. Finally, implications for future research and practice are suggested. Design/methodology/approach – As a commentary this paper draws on the available literature to synthesise what is already known about the relationship between psychoactive substances and sexual functioning. Findings – The limited literature and lack of research attention given to psychotropic induced sexual dysfunction limits our collective understanding of how many people are affected and in what way. Research limitations/implications – A greater focus on psychotropic induced sexual dysfunction is needed for people with a dual diagnosis. There has been an over reliance on single case studies and self-reporting. Large scale epidemiological investigation would help understand the extent and nature of the problem more fully. The demographic shift particularly in relation to an ageing population should be considered as psychotropic substances effect individuals in different ways as they grow older. Practical implications – There is scope for workers to engage more fully in a conversation with clients about their experience of using psychotropic substances and how this has impacted their sexual functioning. The literature suggests that clients want to talk about this issue but staff are unwilling or unable to discuss the topic. Originality/value – To the authors’ knowledge this is the first paper that draws on the available literature to explore the known and likely implications of psychotropic induced sexual dysfunction for this client group.

Purpose -Adverse drug reactions (ADR) and interactions for patients who use substances and have a mental health problem is an area that lacks attention in research, practice and policy. The purpose of this paper is to examine what is currently known about this topic. Design/methodology/approach -The paper explores the available literature and specialist information available on this subject. Findings -This is a complex area, which is compounded by limited empirical evidence. However, information is available which when combined with individual patient assessment there is the potential to reduce the risk of detrimental ADR and improve concordance to medication. Originality/value -The paper offers pragmatic suggestions which aim to improve the knowledge of practitioners and lessen the potential harm to patients.

This article outlines the key areas for nurse prescribers to consider when involved in the clinical management of service users experiencing psychosis or schizophrenia. The author considers key issues concerning mental health service users, including the side effects and physical health implications of being prescribed antipsychotic medication. Consideration is also given to the latest guidance on the management of psychosis and schizophrenia in young people and children ( National Institute for Health and Care Excellence (NICE), 2013 ).

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