Sexual Dysfunction and Plasma Prolactin Levels in Neuroleptic-treated Schizophrenic Outpatients

Ghadirian, A. M.; Chouinard, Guy; Annable, Lawrence

doi:10.1097/00005053-198208000-00004

Cited by 212 publications

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“…It is a well reported fact that the prevalence of ADRs is more in case of females than the males. [6,10] Increase in weight, increased appetite, sedation, and akathesia were the most common ADRs observed in our study population in decreasing order of their occurrence. When compared to other studies [5,1] conducted earlier, weight gain was reported as the most common ADR while as others like Prajapati HK et al [11] had observed that tremor was the most common ADR followed by weight gain.…”

Section: Discussionmentioning

confidence: 64%

“…The most important are those on the cardiovascular, central, autonomic nervous system and endocrine systems. [2,[4][5][6] Knowledge of how the prevalence and severity of adverse effects vary for different antipsychotics allows the clinicians to choose the safer therapy for his patients and reduce the occurrence of these effects. [7] The present study was aimed to assess the severity of various adverse drug reactions (ADRs) associated with the utilization of various antipsychotics used in our patient suffering from different psychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Severity of Adverse Drug Reactions (ADRs) in patients subjected to different Anti-psychotic drugs in an Out-Patient Department of a Psychiatry Hospital in Kashmir; a prospective observational study

Ahmad¹,

Hussain²,

Farhat³

et al. 2016

IJPCS

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Background: Adverse effects are usually dose dependent and can be influenced by patient characteristics including age and gender and these confounding factors should be considered in clinical practice and in the interpretation of research data. Selection of an antipsychotic drug should be on an individual patient basis. Patients should be involved in prescribing decisions and this should involve discussion about adverse drug reactions and their severity. Objective: Current study was carried out with the aim to look into the severity with which the adverse drug reactions were associated with various antipsychotics used in our day to day practice. Materials and Methods: It was a prospective observational study conducted over a period of one year in the Outpatient Department of Institute of Mental Health and Neurosciences (IMHNS), Government Medical College Srinagar. An assessment of severity was done using modified Hartwig and Siegel scale. Results: A total of 100 ADRs of different types were observed in 77 patients out of total 177 patients included in our study, with an overall prevalence of about 43.5%. Most (83.0%) of the ADRs were mild in severity while ADRs moderate in severity were found in only 17 (17.0%) according to modified Hartwig and Siegel scale. None of the reported ADRs belonged to 'severe' or 'lethal' category. There was no statistically significant relationship between development of ADRs with age (p=0.8) or sex (p=0.6) of the patients included in the study. Conclusion: Although with the utilization of antipsychotics, the prevalence of ADRs in our study was as high 43.5%, most of them (83%) were mild in nature and only 17% of them were of moderate severity and none of our patients showed the development of any severe ADR which would lead them to discontinue the therapy.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Prevalence and Severity of Adverse Drug Reactions (ADRs) in patients subjected to different Anti-psychotic drugs in an Out-Patient Department of a Psychiatry Hospital in Kashmir; a prospective observational study

Ahmad¹,

Hussain²,

Farhat³

et al. 2016

IJPCS

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“…Other studies have documented much higher rates: for example those of Macdonald et al [ 38 ] (82 % of men and 96 % of women) and Fan et al [ 39 ] (between 65 % and 94 % for both sexes, depending on the diff erent scales used). Other studies have reported lower rates: approximately 58 % of men and 33 % of women in the study by Ghadirian et al [ 40 ] , 59.3 % of men and 49.1 % of women in the study by Fujii et al [ 41 ] while only 10 % (for both sexes) in the research by Knegtering et al [ 42 ] . The variation in prevalence rates is related to several factors, but is mainly due to the diff erent methodological approaches adopted by diff erent studies: studies that relied only on spontaneous reporting of side eff ects, report low rates of sexual dysfunction, while studies using structured interviews or questionnaires show higher rates of sexual dysfunction [ 3 , 11 , 12 ] .…”

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confidence: 81%

Untitled

2013

Pharmacopsychiatry

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▼Sexual dysfunction is a potential side eff ect of antipsychotic drugs: this article presents a critical review of the current literature. Although many studies have been published on the subject, only some used a validated sexual function rating scale and most lacked either a baseline or placebo control or both. In addition, many of the studies on sexual dysfunction associated with antipsychotic medication are limited by other methodological fl aws. However, there is consistent evidence to suggest that a large number of antipsychotic drugs adversely aff ect one or more of the 3 phases of sexual response (desire, arousal and orgasm). Among the antipsychotics, the so called "prolactin-raising" are probably most associated with sexual dysfunction, even if further studies to confi rm this are needed: the reviewed literature shows no consistent evidence that any one antipsychotic drug has a signifi cantly superior side eff ect profi le over another and current information on this topic is often based on methodologically weak research. Clinicians must be aware of drug-induced sexual dysfunction, since its presence can have important consequences for clinical management and compliance.This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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“…Research work on the endocrine impact of risperidone shows a high rate of sexual dysfunction [7] that is still less compared to others [8]. Under reporting is a possibility for this discrepancy that again can be due to "lack of extensive questionnaire, culture specific factors, and stigma related issues", as suggested by the authors [7].…”

Section: Treatment Of Antidepressant-induced Sexual Dysfunctionmentioning

confidence: 99%

Psychotropic Use and Sexual Dysfunction: Is There a Practical Solution?

Das¹

2017

J Trauma Treat

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The psychotropic medications that we commonly use in our day-to-day life clinical practice are comparable to the players of a football team. If benzodiazepine, whether it is lorazepam, clonazepam, or clobazam is our goalkeeper, then in a 4-3-3 formation we have four strong defenders in the form of fluoxetine, sertraline, paroxetine, and escitalopram. If Lithium is our central defensive midfielder, then the two wingers of our team are valproate and carbamazepine. With quetiapine as our central attacking midfielder, the two lethal strikers at our disposal are risperidone and olanzapine. Thus, we have a good team of 11 players. And we are ready for our game against psychiatric disorders. But, like injury being commonplace for players in a football field, also we have to deal with adverse effects in our practice; sexual dysfunction is one of them. From a category-based classification of psychotropic medications, we are moving towards a mechanism-based one. Talking about mechanisms, prolactin raising 'antipsychotic' is responsible for sexual dysfunction associated with psychotropic use. 'Antidepressant' with higher serotonergic property can also cause sexual dysfunction. There are practical solutions to the problem. Prolactin sparing antipsychotic has less potential to cause sexual dysfunction. Among antidepressants, mirtazapine and bupropion are useful agents. At times, treatment with molecules like sildenafil is necessary. When we combine with this pharmacological approach that of psychosocial intervention, we arrive at a synergic reaction. The ultimate goal is to tailor make our treatment, or in other words 'personalised medicine in psychiatry'.

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Sexual Dysfunction and Plasma Prolactin Levels in Neuroleptic-treated Schizophrenic Outpatients

Cited by 212 publications

References 0 publications

Prevalence and Severity of Adverse Drug Reactions (ADRs) in patients subjected to different Anti-psychotic drugs in an Out-Patient Department of a Psychiatry Hospital in Kashmir; a prospective observational study

Prevalence and Severity of Adverse Drug Reactions (ADRs) in patients subjected to different Anti-psychotic drugs in an Out-Patient Department of a Psychiatry Hospital in Kashmir; a prospective observational study

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Psychotropic Use and Sexual Dysfunction: Is There a Practical Solution?

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