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A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics

Serretti, Alessandro; Chiesa, Alberto

International Clinical Psychopharmacology: May 2011 - Volume 26 - Issue 3 - p 130–140
doi: 10.1097/YIC.0b013e328341e434

The aim of this meta-analysis was to quantify sexual dysfunction (SD) in patients treated with antipsychotics on the basis of selected papers that specifically investigated this type of adverse events by means of adequate instruments. A literature research was conducted using three electronic databases. Studies providing measures of SD in patients taking antipsychotics and providing separate data on single drugs were considered for inclusion. Our primary outcome measure was the rate of total SD, and our secondary outcome measures were the rates of desire, arousal, and orgasm dysfunction. We found that significant differences exist across different antipsychotics in terms of total SD, such that, partially consistent with the traditional dichotomy between prolactin-raising and prolactin-sparing antipsychotics, quetiapine, ziprasidone, perphenazine, and aripiprazole were associated with relatively low SD rates (16–27%), whereas olanzapine, risperidone, haloperidol, clozapine, and thioridazine were associated with higher SD rates (40–60%). Apart from a few exceptions, secondary analyses substantially confirmed the primary outcome measure. However, sensitivity analyses showed a significant impact of several variables on SD rates. In addition, taking into account several limitations, including the difficulty to disentangle SD related to drugs from SD related to illness itself, further studies are needed to determine more thorough evidence concerning antipsychotic-induced SD.

Institute of Psychiatry, University of Bologna, Italy

Correspondence to Alessandro Serretti, MD, PhD, Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, Bologna 40123, Italy Tel: +39 51 6584233; fax: +39 51 521030; e-mail:

Received September 13, 2010

Accepted October 25, 2010

© 2011 Lippincott Williams & Wilkins, Inc.