Drug-induced sexual dysfunction

Abstract

Drug-induced sexual dysfunction is a common barrier to the treatment of mental illnesses. To further confound the matter, disease states such as depression, schizophrenia, diabetes, and hypertension all can decrease sexual desire and increase difficulty with erectile function and problems with orgasm. An assessment of baseline sexual functioning is often overlooked, making it difficult to determine whether the illness or the medication is responsible for the problems. Patients should be informed about the possibility of this side effect and encouraged to report any changes in functioning to their physician. Three main stages of sexual function are affected by medications, including: desire-libido; arousal-priapism and impotence (erectile dysfunction); and orgasmanorgasmia, delayed ejaculation, and painful orgasm. Treatment strategies include decreasing the dose of the current pharmacologic therapy, switching to another class of medication, or adding another agent. Treatment of sexual dysfunction will help to improve medication compliance, thereby reducing the risk of a relapse.