The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia

Title:The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia

Volume: 19 Issue: 12

Author(s): Raja Lope Adam, Hatta Sidi*, Marhani Midin, Hazli Zakaria, Srijit Das and Khairi Che Mat

Affiliation:

• Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur,Malaysia

Keywords: Atypical antipsychotics, sexuality, recovery, schizophrenia, psychoeducation, psychotherapy.

Abstract: Sexuality is an important dimension in human beings as a form of expression of individuality. For many decades, sexual functioning has been a neglected area among patients suffering from schizophrenia. It was a presumption that patients with schizophrenia could be asexual and this could be secondary to overwhelming situations of delusion, hallucination, hostility and negative symptoms among others. The deficient in sexual functioning are due to innate factors, i.e. negative symptoms (apathy, avolition and amotivation) and also as a result of prefrontal dysfunction, i.e. inability to plan and execute meaningful relationship. Adverse effects of the psychopharmacological agents, especially the typical antipsychotics, e.g. dystonia, excessive sedation and hyperprolactinemia may interfere with patients’ sexual activity. In this review, we highlight the neurobiology of schizophrenia in the context of understanding sexual functioning and to integrate the knowledge of dopamine-serotonin neurotransmitter's interaction and the receptors’ target. Interventional approaches consist of psychopharmacological and psychosocial interventions. In the perspective of sexuality, we recommend atypical antipsychotic should be placed as the first line treatment for both drug naïve patients and also to patients who are already receiving psychopharmacological agents in consideration for a drug-switch from typical to atypical antipsychotics. Aripiprazole, clozapine, olanzapine and quetiapine exert benefits in terms of sexual functioning recovery due to their atypical mechanism of action. However, the potential adverse effect like metabolic syndrome should be adequately managed to prevent negative consequences. Psychosocial interventions, i.e. psychoeducation, destigmatization, supportive psychotherapy and psychiatric rehabilitation also play a crucial role in the management. In conclusion, restoration of sexual function is an achievable recovery target in patients with schizophrenia through these biopsycho- social interventions.

Cite this article as:

Adam Lope Raja , Sidi Hatta *, Midin Marhani , Zakaria Hazli , Das Srijit and Mat Che Khairi , The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia, Current Drug Targets 2018; 19 (12) . https://dx.doi.org/10.2174/1389450118666170502130126