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Improvement in Antipsychotic-Related Sexual Dysfunction After Switching to Cariprazine: A Prospective Real-World
Ángel L Montejo1,2,3, Juan C Fiorini4, Pedro Megía4
1Psychiatry Service, Hospital Clínico Universitario de Salamanca, 37007 Salamanca, Spain.
Journal of Clinical Medicine
|May 13, 2026
Summary
Switching to cariprazine significantly improved sexual function in patients with schizophrenia spectrum disorders, particularly those with antipsychotic-related sexual dysfunction. This prolactin-sparing strategy offers meaningful clinical benefits in real-world settings.
Area of Science:
- Psychiatry
- Pharmacology
- Sexual Medicine
Background:
- Sexual dysfunction is a common adverse effect of antipsychotic medications.
- This dysfunction significantly impacts patient adherence and quality of life.
- Limited evidence exists on the effectiveness of switching to prolactin-sparing antipsychotics in clinical practice.
Purpose of the Study:
- To evaluate changes in sexual function after initiating or switching to cariprazine.
- To assess cariprazine's impact on sexual dysfunction in patients with schizophrenia spectrum disorders in a real-world setting.
Main Methods:
- Prospective observational study involving adult outpatients with schizophrenia spectrum disorders.
- Patients were either initiated on cariprazine (Group A) or switched to cariprazine due to sexual dysfunction (Group B).
- Sexual function was assessed using the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX); prolactin levels and symptom scores were secondary measures.
Main Results:
- Switching to cariprazine (Group B) resulted in a significant decrease in SALSEX scores (d = 2.27), indicating large improvement in sexual function.
- Initiating cariprazine (Group A) showed a modest but significant reduction in SALSEX scores (d = 0.93).
- Improvements in sexual function were independent of overall symptom improvement or endocrine normalization.
Conclusions:
- Switching to cariprazine is associated with significant and clinically meaningful improvements in sexual function for patients experiencing antipsychotic-related sexual dysfunction.
- The benefits of cariprazine in sexual function appear independent of overall symptom control.
- Prolactin-sparing switching strategies with cariprazine demonstrate clinical value in real-world patient care.
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