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Sexual Dysfunction with Antipsychotics: Emerging Clues from a Disproportionality Analysis of the World Health
Efstathios Pavlidis1,2, Spyridon Siafis3,4, Elena Arzenton5
1Psychiatric University Hospital Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.
Drug Safety
|April 14, 2026
Summary
Antipsychotic medications can cause sexual side effects in both men and women, such as erectile dysfunction and decreased libido. These adverse drug reactions (ADRs) may be a class effect but appear to be reversible.
Area of Science:
- Pharmacovigilance
- Clinical Pharmacology
- Drug Safety
Background:
- Sexual adverse drug reactions (ADRs) are a known clinical issue with antipsychotics.
- Limited understanding exists regarding differences in sexual ADRs between various antipsychotic medications.
Purpose of the Study:
- To assess and prioritize antipsychotic profiles concerning sexual ADR reporting.
- To identify and account for potential confounding factors in sexual ADRs.
Main Methods:
- A case/non-case study was conducted using VigiBase® data.
- Disproportionality measures (ROR, IC) identified signals of disproportionate reporting (SDRs).
- Sensitivity analyses and stratification by sex were performed to refine findings.
Main Results:
- Significant SDRs for erectile dysfunction and priapism in males, and decreased libido in females were identified across most antipsychotic classes.
- Risperidone, aripiprazole, and olanzapine had the highest report counts for sexual ADRs.
- SDRs diminished in sensitivity analyses excluding non-serious cases or including hyperprolactinemia.
Conclusions:
- Sexual ADRs may represent a class effect of antipsychotics, potentially reversible in both sexes.
- Findings highlight the need for further investigation into antipsychotic-induced sexual dysfunction.
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