Abstract | BACKGROUND: AIM: To review the evidence concerning male sexual dysfunctions in patients taking psychotropic drugs to provide specific information to nonpsychiatric physicians for the management of these dysfunctions. METHODS: A systematic search of Medline and Embase databases was performed up to October 15th, 2020. We included randomized controlled trials comparing the effects of psychotropic drugs versus placebo or versus another drug of the same class, for at least 5 weeks. OUTCOMES: We considered studies whose male population could be evaluated separately from the female population and with a separate analysis of the different phases of the male sex cycle. RESULTS: We included 41 studies in the final review. There was a significant association between sexual dysfunction and antidepressant drug therapy, compared to placebo (decreased libido OR 1.89, 95% CI:1.40 to 2.56, 22 series, 11 trials, 7706 participants; erectile dysfunction OR = 2.28, 95% CI: 1.31 to 3.97; 11 trials, 3008 participants; ejaculatory dysfunction OR = 7.31, 95% CI: 4.38 to 12.20,19 trials, 3973 participants). When the effects of selective serotonin reuptake inhibitors ( SSRIs) were evaluated separately from those of serotonin/ norepinephrine reuptake inhibitors ( SNRIs), the use of SNRIs but not that of SSRIs was characterized by significantly higher odds of erectile dysfunction compared to placebo. Only limited data were found regarding the effects of antipsychotics on the phases of the male sexual cycle, as it was shown that aripiprazole and risperidone showed lower and higher odds for erectile or ejaculatory dysfunction, respectively, compared to other atypical antipsychotics. CLINICAL IMPLICATIONS: Treatment of male sexual dysfunction in patients taking psychotropics requires a basic knowledge of the different drugs that affect sexual function with different mechanisms. STRENGTHS & LIMITATIONS: The effects of psychotropic drugs on erectile function and ejaculation were evaluated separately. The great variability of the mechanisms of action makes it difficult to make comparisons between the effects of the different classes of psychotropic drugs. CONCLUSIONS:
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Authors | Margherita Trinchieri, Martina Trinchieri, Gianpaolo Perletti, Vittorio Magri, Konstantinos Stamatiou, Tommaso Cai, Emanuele Montanari, Alberto Trinchieri |
Journal | The journal of sexual medicine
(J Sex Med)
Vol. 18
Issue 8
Pg. 1354-1363
(08 2021)
ISSN: 1743-6109 [Electronic] Netherlands |
PMID | 34247952
(Publication Type: Journal Article, Review, Systematic Review)
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Copyright | Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Antidepressive Agents
- Psychotropic Drugs
- Serotonin Uptake Inhibitors
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Topics |
- Antidepressive Agents
(therapeutic use)
- Ejaculation
- Erectile Dysfunction
(chemically induced, drug therapy)
- Female
- Humans
- Male
- Psychotropic Drugs
(adverse effects)
- Selective Serotonin Reuptake Inhibitors
(therapeutic use)
- Sexual Dysfunction, Physiological
(chemically induced, drug therapy)
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