Ischemic colitis associated with psychotropic drugs

Patel, Yatin J.; Scherl, Newton D.; Elias, Steven M.; Chessler, Richard K.; Zingler, Barry M.

doi:10.1007/bf01300305

Cited by 17 publications

(11 citation statements)

References 6 publications

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“…Even with treatment, 40%-50% of patients can develop erectile dysfunction owing to ischemia and fibrosis of the corpora cavernosa. [45][46][47] Priapism related to treatment with antipsychotics is a rarely occurring effect and has shown up only in case reports, which relate priapism to many different antipsychotics, such as haloperidol, clozapine, risperidone, olanzapine, aripirazole, and quetiapine. Antipsychotics with strong α 1 -and α 2 -antagonistic properties seem to induce priapism most frequently.…”

Section: Sexual Arousal: Priapismmentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

139

115

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A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.

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Section: Sexual Arousal: Priapismmentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

139

115

View full text Add to dashboard Cite

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“…chlorpromazine or thioridazine) can prevent detumescence but can also cause painful prolonged erection of the penis or clitoris. About 20% of cases of drug-induced priapism are due to antipsychotic drugs; the risk seems independent of dosage or duration of treatment (Patel et al, 1996).…”

Section: Sexual Side-effects Of Conventional Antipsychoticsmentioning

confidence: 99%

Sexual side-effects of antidepressant and antipsychotic drugs

Baldwin¹,

Mayers

2003

Adv. psychiatr. treat

151

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Adequate sexual expression is essential to many human relationships and provides a sense of physical, psychological and social well-being. Epidemiological and clinical studies show that depression and schizophrenia are associated with impairment of sexual function and satisfaction, even in untreated patients. Most antidepressant and antipsychotic drugs have adverse sexual effects but it is difficult accurately to identify the incidence of treatment-emergent dysfunction, as disturbances can be reliably detected only from systematic enquiries made at baseline and during treatment. Growing awareness of the adverse effects of psychotropic drugs has led to attempts to use adjuvants or substitute treatments to resolve sexual dysfunction. More studies of the effects of antidepressant and antipsychotic drugs on sexual function are needed. AbstractThe normal sexual response is conventionally divided into the four phases listed below, and disorders can occur at one or more of these phases.(1) Desire: typically this consists of fantasies about, and the desire to have, sexual activity. (2) Excitement: a subjective sense of sexual pleasure and accompanying physiological changes, namely penile tumescence and erection in men and pelvic vasocongestion, swelling of the external genitalia, vaginal lubrication and expansion in women. (3) Orgasm: this is when sexual pleasure peaks, with release of sexual tension and rhythmic contraction of the perineal muscles and reproductive organs. In men, the sensation of ejaculatory inevitability is followed by ejaculation of semen. In women, contractions of the outer third of the vaginal wall occur. (4) Resolution: a sense of muscular relaxation and general well-being. Men are physiologically refractory to erection and orgasm for a variable period after orgasm, whereas women may respond to further stimulation.The ICD-10 (World Health Organization, 1992) uses the term 'sexual dysfunction' to cover the ways in which an individual is unable to participate in a sexual relationship as he or she would wish. This classification has 10 subdivisions (F52.0-F52.9), each describing different forms of dysfunction. The DSM-IV (American Psychiatric Association, 1994) uses a similar scheme. Whenever possible, doctors should specify which form of sexual dysfunction is present, as these have differing causes and require different treatment approaches.Some types of dysfunction occur in both men and women, although women tend to present with complaints about the subjective quality of sexual experience (e.g. lack of desire), whereas men often describe the failure of a specific response (such as erection) but a continuing sexual desire. Epidemiology of sexual dysfunctionThis area has not been studied extensively. Nathan (1986) evaluated 22 studies of sexual behaviour in the general population but concluded that methodological problems in the surveys meant that only broad estimates could be made. The prevalence of inhibited sexual desire was 16% for men, 35% for women; for erectile dysfunction and premature ejacul...

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“…Trazodone is the drug most frequently associated with priapism (Warner et al, 1987). This problem has also been reported with phenothiazines, butyrophenones and benzisoxazoles (Patel et al, 1996). Antipsychotic drugs, however, have a predominantly depressant effect on sexual function through their effects on the dopaminergic system.…”

Section: Pharmacological Agents and Sexual Dysfunctionmentioning

confidence: 78%

Sexual dysfunction in old age

Phanjoo¹

2000

Adv. psychiatr. treat

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The sexual behaviour of older people is more often the target of jocularity or ridicule than the subject of serious scientific research. As a consequence, relatively little is known about the sexual behaviour of the over-65s and such information as is available shows a polarisation according to gender, male sexual behaviour and dysfunction being viewed very much in the light of physical problems, whereas women's sexual behaviour revolves around attitudes towards sexuality and the psychological effects of ageing. This review will address the biological changes associated with ageing, the psychological and social concomitants, the prevalence of sexual dysfunction, its aetiological factors, and the management of common sexual problems including those found in an institutional setting. Biological changesMasters and Johnson described the physiology of coitus as having four components. Excitement, plateau, orgasm and resolution, all of which show age related changes. As ageing increases, desire may not always result in sexual excitement. The triggers for sexual excitement become more specifically sexual and may require intimate body contact and manual stimulation. The intensity of sexual fantasies decreases and it may take a man longer to achieve an erection and following ejaculation more time before an erection is possible. The physiological changes are listed in Box 1. In addition, older men experience anatomical changes, including thinning of the pubic hair, laxity of scrotal tissue, atrophy of the perineal muscles, loss of collagen tissue and occasionally weight gain. The phase of ejaculation undergoes changes which result in a decline in the intensity of orgasm and in the propulsive force of ejaculation. The volume of the ejaculate may be reduced by 50%. Sex drive and performance vary widely between individuals of the same group and the maintenance of sexual activity depends on factors such as regular sexual activity, the presence of a willing sexual partner, the absence of a major physical illness and the integrity of the relationship.Age-related changes in women (see Box 2) include thinning of the pubic hair, shrinkage of the labia, thinning of the vaginal mucosa and laxity of the perineal muscle. The thinning of the vaginal mucosa and the reduced lubrication may lead to dyspareunia and bleeding during intercourse. Orgasmic contractions may become painful.The ageing male experiences a reduction in the activity of the cells of Leydig with an associated drop in testosterone of 0.4-0.8% per year after the age of 50. Interested readers are referred to a Box 1. Physiological changes in ageing men Sexual organ atrophy Diminished testosterone level Delay in attaining erectionErection of poor quality Longer delay in achieving and maintaining a full penile erection Decline in intensity of orgasm Decreased hormone levels are associated with reduced desire

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Ischemic colitis associated with psychotropic drugs

Cited by 17 publications

References 6 publications

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Sexual side-effects of antidepressant and antipsychotic drugs

Sexual dysfunction in old age

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