Impact of Atypical Antipsychotics on Sexual Dysfunction
S. Aouadi, A. Aissa, Y. Ben Othman, A. Hlaoui, R. Hosni, R. JomliIntroduction
Atypical antipsychotics (AAPs) are commonly prescribed in psychiatry. However, their effects on sexual function remain underestimated, despite significantly impacting quality of life and treatment adherence.
Objectives
To evaluate the prevalence of sexual dysfunction (SD) induced by AAPs in stabilized patients and to identify associated factors.
Methods
A cross-sectional observational study was conducted in the Avicenne Psychiatry Department at the El Razi Psychiatric Hospital in Tunis between January and April 2025. Thirty-six stabilized outpatients treated with AAPs were included. Data were collected using a pre-established form and two assessment tools: the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX) and the Arizona Sexual Experience Scale (ASEX). Statistical analysis was performed using IBM SPSS 25.
Results
The mean age of the patients was 42 years (range: 28-66), with a male predominance (70.6%). 54% had not exceeded secondary school level, and 58% were unemployed with a low socioeconomic status. Regarding lifestyle habits, 94.1% of patients were smokers, and 94.1% consumed alcohol and cannabis. Clinically, 29.4% of patients were diagnosed with type 1 bipolar disorder, 29.4% with schizophrenia, 17.6% with type 2 bipolar disorder, and 21.6% with schizoaffective disorder.
The prevalence of sexual dysfunction was 42%, distributed as 31% moderate and 15% severe. Among the affected patients, 47% were in a relationship, of whom 16% reported marital conflicts. However, no significant correlation was found between marital conflicts and SD (p = 0.569). Furthermore, 47% had no sexual education, while 53% had a “taboo” based education, with no significant link to SD (p = 0.226).
Analysis of treatments revealed that 26% of patients were on clozapine, 26% on risperidone, 47% on olanzapine, and 10% on amisulpride. A significant association was observed between SD and risperidone (p = 0.041) and a trend towards significance with amisulpride (p = 0.067). In contrast, no significant correlation was found with the other AAPs.
Conclusions
Atypical antipsychotics present a differential risk for SD, with a more pronounced impact observed with risperidone and amisulpride. Systematic evaluation of these side effects is essential to optimize treatment adherence and patient quality of life.
Disclosure of Interest
None Declared