olanzapine and Sexual-Dysfunctions--Psychological

Adverse effects of antipsychotics often lead to noncompliance. Thus, clinicians should address patients' concerns about adverse effects and attempt to choose medications that will improve their patients' quality of life as well as overall health. The side effect profiles of the atypical antipsychotics are more advantageous than those of the conventional neuroleptics. Conventional agents are associated with unwanted central nervous system effects, including extrapyramidal symptoms (EPS), tardive dyskinesia, sedation, and possible impairment of some cognitive measures, as well as cardiac effects, orthostatic hypotension, hepatic changes, anticholinergic side effects, sexual dysfunction, and weight gain. The newer atypical agents have a lower risk of EPS, but are associated in varying degrees with sedation, cardiovascular effects, anticholinergic effects, weight gain, sexual dysfunction, hepatic effects, lowered seizure threshold (primarily clozapine), and agranulocytosis (clozapine only). Since the incidence and severity of specific adverse effects differ among the various atypicals, the clinician should carefully consider which side effects are most likely to lead to the individual's dissatisfaction and noncompliance before choosing an antipsychotic for a particular patient.

Topics: Agranulocytosis; Antipsychotic Agents; Basal Ganglia Diseases; Benzodiazepines; Central Nervous System Diseases; Clozapine; Dibenzothiazepines; Drug Interactions; Dyskinesia, Drug-Induced; Health Status; Humans; Hypotension, Orthostatic; Olanzapine; Pirenzepine; Quality of Life; Quetiapine Fumarate; Receptors, Cholinergic; Risperidone; Schizophrenia; Sexual Dysfunctions, Psychological; Sleep Wake Disorders; Treatment Refusal; Weight Gain

This study was conducted to prospectively examine the effect of switching from risperidone to olanzapine on female schizophrenia patients who experienced menstrual disturbances, galactorrhea, and/or sexual dysfunction.. Twenty female patients with DSM-IV schizophrenia who were taking risperidone and were suffering from menstrual disturbances, galactorrhea, and/or sexual dysfunction were enrolled. Patients were switched from risperidone to olanzapine over a 2-week period, then treated with olanzapine for 8 additional weeks. The serum prolactin concentrations were examined every 2 weeks. The Positive and Negative Syndrome Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Scale for Extrapyramidal Symptoms (SAS), and questions from the Dickson-Glazer Sexual Functioning Scale were administered to evaluate efficacy, extrapyramidal side effects, and sexual and reproductive functioning at baseline and the endpoint of 10 weeks.. Serum prolactin levels decreased significantly (p < .01) following the switch from risperidone to olanzapine. Scores of PANSS, AIMS, and SAS at the endpoint were also significantly decreased (p < .01) compared to those of baseline. Patients experienced improvements in menstrual functioning and perceptions of sexual side effects.. Olanzapine reversed hyperprolactinemia in risperidone-treated female schizophrenic patients. This was associated with a decrease in amenorrhea, improved cycle regularity, and a decrease in sexual side effects that the women attributed to antipsychotic medication. This study suggests that switching to olanzapine is a safe and effective alternative method for patients with antipsychotic-induced hyperprolactinemia associated sexual and/or reproductive dysfunction. Long-term follow-up studies are warranted, with particular attention to the course of sexual and reproductive dysfunction.

Topics: Adolescent; Adult; Amenorrhea; Antipsychotic Agents; Basal Ganglia Diseases; Benzodiazepines; Female; Galactorrhea; Humans; Hyperprolactinemia; Menstruation Disturbances; Middle Aged; Olanzapine; Pirenzepine; Prolactin; Prospective Studies; Risperidone; Schizophrenia; Sexual Dysfunctions, Psychological; Treatment Outcome

Antipsychotic-induced sexual dysfunction is a common problem in patients with schizophrenia. The aim of the study was to investigate the effect of switching to aripiprazole on sexual dysfunction and the hypothalamic-pituitary-gonadal axis in male patients with schizophrenia. In this prospective, open-label study, the participants were 10 male schizophrenia patients treated with atypical antipsychotics, risperidone, amisulpride, and olanzapine. Before and after switching to aripiprazole, they were assessed on the Arizona Sexual Experience Scale, and hormonal levels were measured. Our results showed a significant improvement in the severity of sexual dysfunction, especially in 'ease of sexual arousal' and 'penile erection,' as measured by the Arizona Sexual Experience Scale total scores after switching to aripiprazole (χ(2) = 12.45 and P = 0.002). The serum prolactin level decreased significantly after switching to aripiprazole (χ(2) = 11.14 and P = 0.004), but the changes in the total testosterone level were not significant (χ(2) = 4.75 and P = 0.93). Our results suggest that sexual dysfunction in schizophrenia patients seems to improve after switching to aripiprazole from other atypical antipsychotics (risperiodone, amisulpride, or olanzapine). This may be associated with a change in dopamine and serotonin transmissions and a decrease in the serum prolactin concentration.

Topics: Adult; Amisulpride; Antipsychotic Agents; Aripiprazole; Benzodiazepines; Estradiol; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Male; Middle Aged; Olanzapine; Pilot Projects; Piperazines; Prolactin; Prospective Studies; Quinolones; Retreatment; Risperidone; Schizophrenia; Sex Hormone-Binding Globulin; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Sulpiride; Testosterone

We report the case of a 30-year-old woman with a rare presentation of early adulthood Huntington's disease (HD) with hypersexuality. It is not known if sexual dysfunction in HD patients is due to a specific brain lesion or adverse psychosocial factors associated with HD. Although there are no evidence-based treatment guidelines for hypersexuality in HD, our patient exhibited significant improvement with olanzapine and haloperidol.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Female; Haloperidol; Humans; Huntington Disease; Olanzapine; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Treatment Outcome

Sixty male patients with schizophrenia and schizophrenia spectrum disorders were studied in the first five years of disease. Characteristics of psychosexual development and sexual behavior were reviewed. Sexual disorders (mostly the decreased libido) developed in patients during the worsening of mental state and were aggravated during the treatment with neuroleptics. The disturbances of ejaculation appeared during the treatment with risperidone and olanzapine but not with quetiapine. Peculiarities of structure and dynamics of sexual disorders in patients were revealed.

Topics: Antipsychotic Agents; Benzodiazepines; Dibenzothiazepines; Humans; Male; Olanzapine; Quetiapine Fumarate; Risperidone; Schizophrenia; Sexual Dysfunctions, Psychological; Young Adult

Topics: Adult; Benzodiazepines; Bipolar Disorder; Dronabinol; Female; Humans; Libido; Olanzapine; Paroxetine; Psychotropic Drugs; Sexual Behavior; Sexual Dysfunctions, Psychological; Treatment Outcome; Valproic Acid

We attempt to demonstrate the association between neuroleptic-induced hyperprolactinemia and sexual dysfunction in schizophrenic patients treated with prolactin-elevating antipsychotics. Our findings indicate that sexual function improved with euprolactinemia in patients switched from treatment with prolactin-elevating antipsychotics to olanzapine.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Ejaculation; Female; Humans; Hyperprolactinemia; Male; Olanzapine; Prolactin; Psychotic Disorders; Risperidone; Sex Characteristics; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological

This study compared characteristics related to sexual history, sexual activities, sexual functioning, and psychological tendencies associated with sexuality in 45 young adults with schizophrenia treated with novel neuroleptics and in 61 young adults from a comparison group. A smaller proportion of young adults with schizophrenia currently had a sexual partner or had ever engaged in sexual relations. They also had sexual relations and sexual desires less often. Whether affected by schizophrenia or not, a smaller proportion of women had ever masturbated, and a smaller proportion of men currently had a sexual partner. Women masturbated less often, felt less sexual desire, and desired sexual relations less often, compared with men. Proportionally more men with schizophrenia treated with risperidone or olanzapine than men in the comparison group had at least one sexual dysfunction, lacked sexual desire, and reported problems with sexual arousal and ejaculation. Women with schizophrenia were more likely to report problems with sexual arousal and galactorrhea, compared with women in the comparison group. Finally, young adults with schizophrenia were more likely to develop negative psychological tendencies associated with sexuality than were young adults in the comparison group. Sexual problems are highly prevalent among young adults with schizophrenia. Sexuality should occupy the space it deserves within psychosocial rehabilitation programs and the treatment of schizophrenia.

Topics: Adolescent; Adult; Affect; Antipsychotic Agents; Benzodiazepines; Female; Humans; Male; Olanzapine; Pirenzepine; Prevalence; Risperidone; Schizophrenia; Schizophrenic Psychology; Severity of Illness Index; Sex Factors; Sexual Behavior; Sexual Dysfunctions, Psychological

Four patients affected by severe Parkinson's disease developed leucopenia (900-1200 WBC) during treatment of psychosis (3) or untreatable insomnia (1) with clozapine (37.5-75 mg/day). Clozapine withdrawal was followed by recovery of leucopenia (4000-6000 WBC) in two weeks with no need for the administration of leucokines. After 1-6 months olanzapine was administered (increasing the dose from 2.5 to 10 mg/day) to treat persisting disturbances, but the drug induced severe worsening of parkinsonism and also this drug had to be withdrawn.

Topics: Aged; Aged, 80 and over; Antipsychotic Agents; Benzodiazepines; Clozapine; Dose-Response Relationship, Drug; Female; Hallucinations; Humans; Leukopenia; Male; Olanzapine; Parkinson Disease; Pirenzepine; Psychotic Disorders; Sexual Dysfunctions, Psychological; Sleep Initiation and Maintenance Disorders

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Humans; Hyperprolactinemia; Male; Olanzapine; Pirenzepine; Prolactin; Risperidone; Schizophrenia; Sexual Dysfunctions, Psychological; Testosterone