The Sexual Side-Effects of Antipsychotics

Neuroleptics or antipsychotics are prescribed for Bipolar Disorder and Schizophrenia. They are used to treat a variety of psychiatric problems, such as preoccupation with troublesome and recurring thoughts, overactivity, and unpleasant and unusual experiences such as hearing and seeing things not normally seen or heard.

Some of the benefits of these antipsychotics may occur in the first few days, but it is not unusual for it to take several weeks or months to see the full benefits. In contrast, many of the side effects are worse when you first start taking it.

Antipsychotics, Prolactin and Sexual Side Effects

Antipsychotics can cause a raising of the body's level of a hormone called prolactin. In women, this can lead to an increase in breast size and irregular periods. In men, it can lead to impotence and the development of breasts. Most of the typical antipsychotic drugs, risperidone and amisulpride have the worst effect.

The best known function of prolactin is the stimulation and maintenance of lactation, but it has also been found to be involved in over 300 separate functions including involvement in water and electrolyte balance, growth and development, endocrinology and metabolism, brain and behavior, reproduction and immunoregulation.

In humans, prolactin is also thought to play a role in the regulation of sexual activity and behavior. It has been observed that orgasms cause a large and sustained (60 min) increase in plasma prolactin in both men and women, which is associated with decreased sexual arousal and function. Furthermore, increased prolactin is thought to promote behaviors that encourage long-term partnership.

Studies of patients who are treatment-naive or who have been withdrawn from treatment for a period of time indicate that schizophrenia per se does not affect prolactin concentrations.

Sexual Problems Among Worst Side Effects

Patients with Schizophrenia and Bipolar Disorder consider sexual dysfunction to be among the most important side effects. Sexual dysfunction includes low sexual desire, difficulty maintaining an erection (for men), difficulty achieving orgasm.

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(If you have any of these symptoms and they are causing you concern, contact your doctor. He/she may be able to reduce your dose or change your medication.)

These adverse antipsychotic sexual side effects can have a serious negative impact on the patient in terms of causing distress, impairing quality of life, contributing to stigma, and on acceptance of treatment.  In fact, many discontinue treatment because of the sexual side effects.

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Last updated: 10/05

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