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The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management
The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.
Sexual health, sexual dysfunction, severe mental illness, psychosis, depression, bipolar disorder, antipsychotics, antidepressants,
2051-5545
3-11
Montejo, Angel L.
0ea482ac-b782-4d3d-aa97-1ab4d31f3388
Montejo, Laura
e506d3c5-28d4-46bc-bb3a-3f96485dd94d
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Montejo, Angel L.
0ea482ac-b782-4d3d-aa97-1ab4d31f3388
Montejo, Laura
e506d3c5-28d4-46bc-bb3a-3f96485dd94d
Baldwin, David
1beaa192-0ef1-4914-897a-3a49fc2ed15e

Montejo, Angel L., Montejo, Laura and Baldwin, David (2018) The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry, 17 (1), 3-11. (doi:10.1002/wps.20509).

Record type: Article

Abstract

Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.

Text World Psychiatry FINAL 30112017 - Accepted Manuscript
Restricted to Repository staff only until 18 January 2019.
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Text Special Article World Psychiatry_17_1_Feb 2018 - Version of Record
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More information

Accepted/In Press date: 1 December 2017
e-pub ahead of print date: 18 January 2018
Published date: February 2018
Keywords: Sexual health, sexual dysfunction, severe mental illness, psychosis, depression, bipolar disorder, antipsychotics, antidepressants,

Identifiers

Local EPrints ID: 417631
URI: https://eprints.soton.ac.uk/id/eprint/417631
ISSN: 2051-5545
PURE UUID: 73b31fe8-ffed-4d7a-9a1e-27c13881071f

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Date deposited: 07 Feb 2018 17:30
Last modified: 26 Apr 2018 16:31

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Contributors

Author: Angel L. Montejo
Author: Laura Montejo
Author: David Baldwin

University divisions

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