Psychotropic Drugs and Sexual Dysfunction

Abstract

Summary

Psychotropic drugs may have adverse effects on any part of the normal pattern and sequence of sexual response. Iatrogenic sexual dysfunction may therefore include the reduction of sexual interest, the impairment or disturbance of physiological arousal, and the loss, delay or alteration of orgasm. Before ascribing an adverse event to a particular drug, many other causes of sexual dysfunction have to be considered, including the features of the primary psychiatric disorder, the presence and severity of any co-morbid mental and physical disorders, and the concomitant use of other drug treatments. The adverse effects of psychotropic drugs on sexual function may result from a range of differing pathophysiological mechanisms. Within the central nervous system, non-specific effects such as sedation may result in a general decrease in the level of sexual interest and activity, and specific effects on various neurotransmitters may lead to circumscribed impairments of sexual arousal and function. Actions on neurotransmitters within the autonomic nervous system may result in an altered pattern of sexual response. Furthermore, many drugs have direct or indirect effects on the regulation of hormones. This paper addresses the issues of management and diagnosis in such cases.