[Psychotropic drug-induced changes in sexuality--frequency and relevance in psychiatric practice]

As a review of the literature concerning sexual side effects of psychotropic drugs in psychiatric patients reveals, sexual disturbances (such as erectile or orgasmic dysfunctions) seem to be a common consequence of psychopharmacological treatment. The frequency and relevance of these effects in psychiatric practice were estimated in a questionnaire study with 68 psychiatrists, working either in a practice or a clinic. According to the physicians answers, few patients report sexual side effects of drugs spontaneously, through these are supposed to be more common. Different kinds of sexual impairment are reported as specific effects of the drugs. As the physicians assume these effects generally provide a problem, both for the patients self-esteem as well as for treatment and compliance. Based on the psychiatrists experience patients are in a surprisingly good position to differentiate between the influences of their basic illness and a specific medication as far as sexual changes are concerned. One part of the questionnaire asked for the observed effects of specific psychotropic substances on sexual behaviour. The results support the evidence reported in the literature that neuroleptics and antidepressants are most likely to provoke sexual impairment. The results of the study are discussed in relation to the theoretical relevance of sexual side effects for the patient and the treatment and to the possibilities of a psychiatrist to prepare and inform his patient.