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Angel L. Montejo - One of the best experts on this subject based on the ideXlab platform.
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Frequency of Sexual Dysfunction in Patients Treated with Desvenlafaxine: A Prospective Naturalistic Study.
Journal of Clinical Medicine, 2019Co-Authors: Angel L. Montejo, Joemir Becker, Raquel Fernández-ovejero, Nerea González, Adrián Juanes, Antonio Pérez-urdániz, Maria T. Gallego, Laura Montejo, Gloria Bueno, N. PrietoAbstract:Despite being clinically underestimated, Sexual Dysfunction (SD) is one of the most frequent and lasting adverse effects associated with antidepressants. Desvenlafaxine is an antidepressant (AD) with noradrenergic and serotonergic action that can cause a lower SD than other serotonergic ADs although there are still few studies on this subject. Objective: To check the frequency of SD in two groups of depressive patients: one group was desvenlafaxine-naive; the other was made up of patients switched to desvenlafaxine from another AD due to iatrogenic Sexual Dysfunction. A naturalistic, multicenter, and prospective study of patients receiving desvenlafaxine (50–100 mg/day) was carried out on 72 patients who met the inclusion criteria (>18 years old and Sexually active), who had received desvenlafaxine for the first time (n = 27) or had switched to desvenlafaxine due to SD with another AD (n = 45). Patients with previous SD, receiving either drugs or presenting a concomitant pathology that interfered with their Sexual life and/or patients who abused alcohol and/or drugs were excluded. We used the validated Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SALSEX) to measure AD-related Sexual Dysfunction and the Clinical Global Impression Scale for psychiatric disease (CGI-S) and for Sexual Dysfunction (CGI-SD) at two points in time: baseline and three months after the commencement of desvenlafaxine treatment. Results: In desvenlafaxine-naive patients, 59.2% of the sample showed moderate/severe Sexual Dysfunction at baseline, which was reduced to 44% at follow-up. The PSexDQ-SALSEX questionnaire total score showed a significant improvement in Sexual desire and Sexual arousal without changes in orgasmic function at follow-up (p < 0.01). In the group switched to desvenlafaxine, the frequency of moderate/severe SD at baseline (93.3%) was reduced to 75.6% at follow-up visit. Additionally, SD significantly improved in three out of four items of the SALSEX: low desire, delayed orgasm, and anorgasmia at follow-up (p < 0.01), but there was no significant improvement in arousal difficulties. The frequency of severe SD was reduced from 73% at baseline to 35% at follow-up. The CGI for psychiatric disease and for Sexual Dysfunction improved significantly in both groups (p < 0.01). There was a poor tolerability with risk of treatment noncompliance in 26.7% of patients with Sexual Dysfunction due to another AD, this significantly reduced to 11.1% in those who switched to desvenlafaxine (p = 0.004). Conclusion: Sexual Dysfunction improved significantly in depressed patients who initiated treatment with desvenlafaxine and in those who switched from another AD to desvenlafaxine, despite this, desvenlafaxine treatment is not completely devoid of Sexual adverse effects. This switching strategy could be highly relevant in clinical practice due to the significant improvement in moderate/severe and poorly tolerated SD, while maintaining the AD efficacy.
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frequency of Sexual Dysfunction in patients with a psychotic disorder receiving antipsychotics
The Journal of Sexual Medicine, 2010Co-Authors: Angel L. Montejo, Susana Majadas, Fernando Ricovillademoros, G Llorca, Jesus De La Gandara, Manuel Franco, Manuel Martincarrasco, L Aguera, N. PrietoAbstract:ABSTRACT Introduction Although it is a troublesome side effect, information on antipsychotic-induced Sexual Dysfunction is limited. Aim To evaluate the frequency of Sexual Dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions. Methods Subjects included were Sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to Sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history. Main Outcome Measure Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex). Results All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited Sexual Dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with Sexual dysfuntion spontaneously reported it. Among the patients exhibiting Sexual Dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females' Sexual funtioning, the severity and tolerance of Sexual Dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73–14.89) and conventionals, depot (OR 4.57, 95% CI 1.72–12.13) and nondepot (OR 4.92, 95% CI 1.43–16.93), showed a significant increased risk of Sexual Dysfunction. Conclusions Our results show that Sexual Dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients. Montejo AL, Majadas S, Rico-Villademoros F, LLorca G, de la Gandara J, Franco M, Martin-Carrasco M, Aguera L, and Prieto N. Frequency of Sexual Dysfunction in patients with a psychotic disorder receiving antipsychotics.
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major depressive disorder antidepressants and Sexual Dysfunction
The Journal of Clinical Psychiatry, 2006Co-Authors: Anita H. Clayton, Angel L. MontejoAbstract:Sexual Dysfunction is a common problem with a number of causes, including psychosocial factors, general medical illness, psychiatric disorders, and psychotropic and nonpsychiatric medications. It is especially prevalent among patients with poor emotional health and has been strongly associated with antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) in particular have demonstrated a higher incidence of Sexual Dysfunction than other antidepressants that work through different mechanisms of action. Further supporting the relationship between Sexual Dysfunction and antidepressant mechanism of action, data from a number of studies indicate that bupropion, nefazodone, and mirtazapine alleviate symptoms of Sexual Dysfunction and are as effective as SSRIs at controlling depressive symptoms. Although a number of strategies besides drug substitution have been utilized to help manage antidepressant-induced Sexual Dysfunction, many patients remain suboptimally treated; as many as 42% of patients were found to passively wait for spontaneous remission. The addition of antidotal therapy has been proven to be among the effective management strategies for Sexual Dysfunction. However, due to a lack of systematic data, additional studies are warranted to further investigate these findings.
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incidence of Sexual Dysfunction associated with antidepressant agents a prospective multicenter study of 1022 outpatients
The Journal of Clinical Psychiatry, 2001Co-Authors: Angel L. Montejo, G Llorca, Fernando RicovillademorosAbstract:Background: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with Sexual Dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer Sexual side effects. The incidence of Sexual Dysfunction is underestimated, and the use of a specific questionnaire is needed. Method: The authors analyzed the incidence of antidepressant-related Sexual Dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal Sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 ± 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general Sexual satisfaction. Results: The overall incidence of Sexual Dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of Sexual Dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of Sexual Dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their Sexual Dysfunction. Conclusion: The incidence of Sexual Dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT 2 ) blockers (nefazodone and mirtazapine), moclobemide, and aminentine.
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incidence of Sexual Dysfunction associated with antidepressant agents a prospective multicenter study of 1022 outpatients spanish working group for the study of psychotropic related Sexual Dysfunction
The Journal of Clinical Psychiatry, 2001Co-Authors: Angel L. Montejo, G Llorca, J A Izquierdo, Fernando RicovillademorosAbstract:Background Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with Sexual Dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer Sexual side effects. The incidence of Sexual Dysfunction is underestimated, and the use of a specific questionnaire is needed. Method The authors analyzed the incidence of antidepressant-related Sexual Dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal Sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general Sexual satisfaction. Results The overall incidence of Sexual Dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of Sexual Dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of Sexual Dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their Sexual Dysfunction. Conclusion The incidence of Sexual Dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.
Fernando Ricovillademoros - One of the best experts on this subject based on the ideXlab platform.
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frequency of Sexual Dysfunction in patients with a psychotic disorder receiving antipsychotics
The Journal of Sexual Medicine, 2010Co-Authors: Angel L. Montejo, Susana Majadas, Fernando Ricovillademoros, G Llorca, Jesus De La Gandara, Manuel Franco, Manuel Martincarrasco, L Aguera, N. PrietoAbstract:ABSTRACT Introduction Although it is a troublesome side effect, information on antipsychotic-induced Sexual Dysfunction is limited. Aim To evaluate the frequency of Sexual Dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions. Methods Subjects included were Sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to Sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history. Main Outcome Measure Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex). Results All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited Sexual Dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with Sexual dysfuntion spontaneously reported it. Among the patients exhibiting Sexual Dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females' Sexual funtioning, the severity and tolerance of Sexual Dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73–14.89) and conventionals, depot (OR 4.57, 95% CI 1.72–12.13) and nondepot (OR 4.92, 95% CI 1.43–16.93), showed a significant increased risk of Sexual Dysfunction. Conclusions Our results show that Sexual Dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients. Montejo AL, Majadas S, Rico-Villademoros F, LLorca G, de la Gandara J, Franco M, Martin-Carrasco M, Aguera L, and Prieto N. Frequency of Sexual Dysfunction in patients with a psychotic disorder receiving antipsychotics.
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incidence of Sexual Dysfunction associated with antidepressant agents a prospective multicenter study of 1022 outpatients
The Journal of Clinical Psychiatry, 2001Co-Authors: Angel L. Montejo, G Llorca, Fernando RicovillademorosAbstract:Background: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with Sexual Dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer Sexual side effects. The incidence of Sexual Dysfunction is underestimated, and the use of a specific questionnaire is needed. Method: The authors analyzed the incidence of antidepressant-related Sexual Dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal Sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 ± 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general Sexual satisfaction. Results: The overall incidence of Sexual Dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of Sexual Dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of Sexual Dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their Sexual Dysfunction. Conclusion: The incidence of Sexual Dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT 2 ) blockers (nefazodone and mirtazapine), moclobemide, and aminentine.
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incidence of Sexual Dysfunction associated with antidepressant agents a prospective multicenter study of 1022 outpatients spanish working group for the study of psychotropic related Sexual Dysfunction
The Journal of Clinical Psychiatry, 2001Co-Authors: Angel L. Montejo, G Llorca, J A Izquierdo, Fernando RicovillademorosAbstract:Background Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with Sexual Dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer Sexual side effects. The incidence of Sexual Dysfunction is underestimated, and the use of a specific questionnaire is needed. Method The authors analyzed the incidence of antidepressant-related Sexual Dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal Sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general Sexual satisfaction. Results The overall incidence of Sexual Dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of Sexual Dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of Sexual Dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their Sexual Dysfunction. Conclusion The incidence of Sexual Dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.
Giovanni Corona - One of the best experts on this subject based on the ideXlab platform.
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definitions epidemiology risk factors for Sexual Dysfunction
The Journal of Sexual Medicine, 2010Co-Authors: Ronald W Lewis, Giovanni Corona, Edward O Laumann, Kerstin S Fuglmeyer, Richard D Hayes, Edson D Moreira, Alessandra H Rellini, Taylor SegravesAbstract:INTRODUCTION: Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female Sexual Dysfunction and in identifying risk factors for prevention efforts. This is the summary of the report by the International Consultation Committee for Sexual Medicine on Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. AIM: The main aim of this article is to provide a general overview of the definitions of Sexual Dysfunction for men and women, the incidence and prevalence rates, and a description of the risk factors identified in large population-based studies. METHODS: Literature regarding definitions, descriptive and analytical epidemiology of Sexual Dysfunction in men and women were selected using evidence-based criteria. For descriptive epidemiological studies, a Prins score of 10 or higher was utilized to identify population-based studies with adequately stringent criteria. This report represents the opinions of eight experts from five countries developed in a consensus process and encompassing a detailed literature review over a 2-year period. MAIN OUTCOME MEASURES: The study aims to provide state-of-the-art prevalence and incidence rates reported for each Dysfunction and stratified by age and gender. Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. RESULTS: A wealth of information is presented on erectile Dysfunction, its development through time, and its correlates. The field is still in need of more epidemiological studies on the other men's Sexual Dysfunction and on all women's Sexual Dysfunctions. CONCLUSIONS: A review of the currently available evidence from epidemiological studies is provided.
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original research epidemiology selective serotonin reuptake inhibitor induced Sexual Dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual Dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se Sexual Dysfunctions. Aim To explore the relationship between the use of selective serotonin reuptake inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported Sexual Dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with Sexual Dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive Sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male Sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated Sexual Dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with Sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin reuptake inhibitor-induced Sexual Dysfunction. J Sex Med 2009;6:1259–1269.
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selective serotonin reuptake inhibitor induced Sexual Dysfunction
The Journal of Sexual Medicine, 2009Co-Authors: Giovanni Corona, Elisa Bandini, Francesco Lotti, Valentina Boddi, Giulia Rastrelli, Alessandra Sforza, Edoardo Mannucci, Carlo Faravelli, Valdo Ricca, Gianni FortiAbstract:ABSTRACT Introduction Sexual Dysfunctions are often present in subjects with mood disturbances; however. antidepressants can induce per se Sexual Dysfunctions. Aim To explore the relationship between the use of selective serotonin reuptake inhibitors (SSRIs), non-SSRIs antidepressants and benzodiazepines (BDZ), hormonal parameters, and reported Sexual Dysfunction (as assessed by the Structured Interview on Erectile Dysfunction [SIEDY]) in male subjects with comparable psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire [MHQ] a self-reported test for the screening of mental disorders in a non-psychiatric setting). Methods A consecutive series of 2,040 (mean age 51 ± 13 years) male patients with Sexual Dysfunction was studied. Main Outcome Measures Several hormonal and biochemical parameters were investigated, along with SIEDY and the MHQ. Results Higher prolactin was observed only in patients using SSRIs, whereas no other hormonal difference was found after adjustment for confounders. Use of SSRIs was associated with a twofold risk for patient hypoactive Sexual desire and with a higher impairment of reported erectile function. However, no difference in penile blood flow was observed. A very high risk (sevenfold) for delayed ejaculation (DE) was observed in SSRI users. Interestingly, the association with the mild, but not severe, form of DE was observed also in subjects using non-SSRI antidepressants (3.35 [1.48–7.59]; P Conclusions SSRIs can negatively affect all the steps of the male Sexual response cycle (desire–arousal–excitement–orgasm). SSRI-associated Sexual Dysfunction has a deleterious effect on both auto- and couple-erotic performances. Conversely, other antidepressants and BDZ are less often associated with Sexual impairment. Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, Rastrelli G, Sforza A, Faravelli C, Forti G, and Maggi M. Selective serotonin reuptake inhibitor-induced Sexual Dysfunction. J Sex Med 2009;6:1259–1269.
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assessment of the relational factor in male patients consulting for Sexual Dysfunction the concept of couple Sexual Dysfunction
Journal of Andrology, 2006Co-Authors: Giovanni Corona, Francesco Lotti, Gianni Forti, Edoardo Mannucci, Valdo Ricca, Luisa Petrone, A Magini, Valerio Chiarini, Mario MaggiAbstract:ABSTRACT: In a consecutive series of 1140 male subjects reporting a stable couple relationship and different degrees of Sexual Dysfunction, we evaluated the impact of relational factors, as assessed by the Structured Interview on Erectile Dysfunction (SIEDY) Scale 2 (exploring, as reported by the patient, menopausal symptoms, partner's medical illness interfering with Sexual activity, and reduced partner desire and climax). We found that the SIEDY Scale 2 is significantly and independently associated with erectile Dysfunction (ED), delayed ejaculation, hypoactive Sexual desire, and decreased frequency of intercourse. SIEDY Scale 2 scores are associated with an advanced age of the partner and a long couple relationship, independently from patient's age. In addition, an increased relational factor correlates with increased extramarital affairs, conflicts in the couple, alcohol abuse, and presence of depressive symptoms, as assessed by the Middlesex Hospital Questionnaire. Our results should encourage the andrologist to consider the context in which Sexual symptoms develop, analyzing the relationship and partner's behaviors and diseases. Resolving, or at least ameliorating, the relational background and the Sexual framework might help in treating male Sexual Dysfunction.
Abraham Weizman - One of the best experts on this subject based on the ideXlab platform.
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the impact of mental illness on Sexual Dysfunction
Advances in Psychosomatic Medicine, 2008Co-Authors: Zvi Zemishlany, Abraham WeizmanAbstract:Sexual Dysfunction is prevalent among psychiatric patients and may be related to both the psychopathology and the pharmacotherapy. The negative symptoms of schizophrenia limit the capability for interpersonal and Sexual relationships. The first-generation antipsychotics cause further deterioration in erectile and orgasmic function. Due to their weak antagonistic activity at D2 receptors, second-generation antipsychotics are associated with fewer Sexual side effects, and thus may provide an option for schizophrenia patients with Sexual Dysfunction. Depression and anxiety are a cause for Sexual Dysfunction that may be aggravated by antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). SSRI-induced Sexual Dysfunction may be overcome by lowering doses, switching to an antidepressant with low propensity to cause Sexual Dysfunction (bupropion, mirtazapine, nefazodone, reboxetine), addition of 5HT2 antagonists (mirtazapine, mianserin) or coadministration of 5-phosphodiesterase inhibitors. Eating disorders and personality disorders, mainly borderline personality disorder, are also associated with Sexual Dysfunction. Sexual Dysfunction in these cases stems from impaired interpersonal relationships and may respond to adequate psychoSexual therapy. It is mandatory to identify the specific Sexual Dysfunction and to treat the patients according to his/her individual psychopathology, current pharmacotherapy and interpersonal relationships.
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cyproheptadine treatment of Sexual Dysfunction induced by serotonin reuptake inhibitors
Clinical Neuropharmacology, 1995Co-Authors: Dov Aizenberg, Z Zemishlany, Abraham WeizmanAbstract:Treatment of serotonin reuptake inhibitors (SRIs) is associated with Sexual Dysfunction. The cause of this Dysfunction is unclear but may be related to stimulation of the serotonergic system. In the present article, we describe seven patients in whom iatrogenic Sexual Dysfunction induced by SRIs was treated with cyproheptadine, a 5HT-2 antagonist with antihistaminergic and adrenolytic properties. Seven obsessive-compulsive male patients, aged 29-54 years, who developed Sexual Dysfunction following treatment with SRIs (fluoxetine, fluvoxamine, and clomipramine) were instructed to take cyproheptadine (4-12 mg) 1-2 h before commencing Sexual activity. Five of the seven patients displayed improvement in Sexual function, although the improvement was transitory in two. The two remaining patients did not respond. All patients exhibited sedation on the day following cyproheptadine administration. Our preliminary observation suggests that some patients with Sexual Dysfunction associated with SRI treatment, mainly decreased libido and anorgasmia, may benefit from cyproheptadine administration. The role of 5HT-2 antagonists in SRI-induced Sexual Dysfunction merits further investigation.
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Sexual Dysfunction in male schizophrenic patients
The Journal of Clinical Psychiatry, 1995Co-Authors: Dov Aizenberg, Z Zemishlany, Pnina Dorfmanetrog, Abraham WeizmanAbstract:Background: Neuroleptic treatment in schizophrenic patients is associated with Sexual Dysfunction. However, it is not clear to what extent the psychiatric disorder and/or the pharmacologic treatment are responsible for the Sexual impairment. The aim of the present study was to evaluate the Sexual function of untreated and treated male schizophrenic patients in comparison with healthy subjects. Method: Participants included 122 male subjects: 20 drug-free schizophrenic patients, 51 neuroleptic-treated (depot form) schizophrenic patients, and 51 normal controls. A detailed structured interview was used to quantitatively and qualitatively assess Sexual function. Results: A high frequency of Sexual Dysfunction was reported by both schizophrenic groups of patients. Impairments in arousal items (erection) and orgasm during sex were reported mainly by the treated patients. Desire parameters were reduced in both schizophrenic groups, but reduction in the frequency of Sexual thoughts was confined to the untreated one. The schizophrenic patients were more involved in masturbatory activity in comparison with the control subjects. Treated patients disclosed dissatisfaction with their Sexual function. Conclusion: Untreated schizophrenic patients exhibit decreased Sexual desire. Neuroleptic treatment is associated with restoration of Sexual desire yet it entails erectile, orgasmic, and Sexual satisfaction problems. Clinicians'awareness and open discussion of Sexual problems with patients may improve comprehension and compliance
Tong Long A Lin - One of the best experts on this subject based on the ideXlab platform.
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Sexual Dysfunction in men with lower urinary tract symptoms
Journal of Clinical Epidemiology, 1998Co-Authors: Stephen Frankel, Jenny L Donovan, T I Peters, Paul Abrams, N F Dabhoiwala, D Osawa, Tong Long A LinAbstract:The conventional view that Sexual function is not adversely affected by lower urinary tract symptoms (LUTS), assumed to be caused by enlargement secondary to benign prostatic hyperplasia (BPH), was investigated in this study of 423 men aged 40 years and over in a community population in the UK and 1271 urology clinic attenders aged 45 years and over in 12 countries, using the ICSmale and ICSsex questionnaires. Sexual Dysfunction was found to be common: in the community, age standardized prevalences of reduced rigidity of erections were 53%, reduced ejaculation 47%, and pain on ejaculation 5%; in clinic men, age standardized prevalences of reduced rigidity of erections were 60%, reduced ejaculation 62%, and pain on ejaculation 17%. Sex lives were reported to be spoiled by LUTS in 8% of community men and 46% in the clinic. There were negative trends for age in the extent to which clinic men were bothered by these symptoms, although older men were still very concerned. Significantly raised odds ratios of Sexual Dysfunction were found in those with LUTS, especially storage symptoms associated with incontinence. Urinary flow rates were not associated with Sexual symptoms. Sexual Dysfunction is, therefore, strongly associated with LUTS, is a matter of concern to the men affected, and should be taken into account when managing patients with LUTS.
