Antipsychotika und sexuelle Dysfunktion

Antipsychotic drugs are used in the treatment of psychotic symptoms in schizophrenia and affective disorders. A direct correlation between increased dopaminergic activity and increased sexual desire and sexual activity is well documented in animal experiments and from observations in humans. Comparatively little researched and recognized is pharmacologically induced sexual dysfunction. In contrast to the antipsychotic effect and extrapyramidal motor side effects, no dose–response relationships are known for sexual side effects. This may be due to the fact that antipsychotics act at different levels in the sexual experience. Sexual dysfunction may be present on social, psychological, central nervous system and peripheral–organic levels, respectively. These levels are closely associated with each other and influence each other. Therefore, sexual dysfunction is generally a combination of dysfunctions at several of these levels. For a variety of reasons, there are no generally accepted standards for a healthy and fulfilling sex life. As a treating physician, the fact that sexual disorders are also not a rare phenomenon in mentally and physically healthy people should be kept in mind and that patients with schizophrenia regardless of the etiology of the sexual dysfunction may also benefit from sexual medicine or specific psychotherapeutic treatment.