Sexual dysfunction in schizophrenia
Abstract
PURPOSE OF REVIEW: Sexual dysfunctions have been described as being common in schizophrenia patients. The pathophysiology behind their development remains unclear. They can be secondary to the disease itself or an adverse event of antipsychotic medication. Therapeutic interventions are also not well studied. RECENT FINDINGS: Earlier work has suggested that second-generation antipsychotics bear fewer risks for developing sexual dysfunction because of a lower propensity to elevate prolactin levels, although the latter does not apply to amisulpride and risperidone. Only a few controlled trials with larger patient samples have been performed in the past. SUMMARY: The review covers studies published from March 2005 to June 2006 focusing on sexual dysfunctions in schizophrenia patients, as well as their possible causes. Treatment options and the impact of sexual dysfunction on quality of life are also covered. The reviewed papers show no clear consistency regarding potential advantages of one drug over another. Many trials suffer from small sample sizes. The field badly needs more and larger studies on this topic.
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This dysfunction can be secondary to the disease itself and to comorbid physical disorders, or be an adverse event of antipsychotics.
“This dysfunction can be secondary to the disease itself and to comorbid physical disorders, or be an adverse event of AP (520,524,525).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [524]
Cites
Lambert, M., Conus, P., Eide, P., Mass, R., Karow, A., Moritz, S., Golks, D., & Naber, D. (2004) · European Psychiatry · doi:10.1016/j.eurpsy.2004.06.031 · Cited by 268 · see citing works
Sexual dysfunction in male schizophrenic patients.
Aizenberg, D., Zemishlany, Z., Dorfman-Etrog, P., & Weizman, A. (1995) · PubMed · Cited by 213 · see citing works
Gitlin, M. J. (1994) · PubMed · Cited by 193 · see citing works
Sexual dysfunction and antipsychotic treatment
Cutler, A. J. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00113-0 · Cited by 176 · see citing works
Nithsdale Schizophrenia Surveys 24: sexual dysfunction: Case–control study
Macdonald, S., Halliday, J., MacEwan, T., Sharkey, V., Farrington, S., Wall, S., & McCreadie, R. G. (2003) · British Journal of Psychiatry · doi:10.1192/bjp.182.1.50 · Cited by 165 · see citing works
Male Sexual Dysfunction and Quality of Life in Schizophrenia
Olfson, M., Uttaro, T., Carson, W. H., & Tafesse, E. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0309 · Cited by 154 · see citing works
A Randomized Open-Label Study of the Impact of Quetiapine Versus Risperidone on Sexual Functioning
Knegtering, R., Castelein, S., Bous, H., van der Linde, J., Bruggeman, R., Kluiter, H., & van den Bosch, R. J. (2004) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000106220.36344.04 · Cited by 147 · see citing works
Dossenbach, M., Dyachkova, Y., Pirildar, S., Anders, M., Khalil, A., Araszkiewicz, A., Shakhnovich, T., Akram, A., Pecenak, J., McBride, M., et al. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2005.12.005 · Cited by 121 · see citing works
Subjective utility ratings of neuroleptics in treating schizophrenia
Finn, S. E., Bailey, J. M., Schultz, R. T., & Faber, R. A. (1990) · Psychological Medicine · doi:10.1017/s0033291700036539 · Cited by 120 · see citing works
Attitudes Toward Antipsychotics Among Outpatient Clinic Attendees With Schizophrenia
Hofer, A., Kemmler, G., Eder, U., Honeder, M., Hummer, M., & Fleischhacker, W. W. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0110 · Cited by 100 · see citing works
Gopalakrishnan, R. M., Jacob, K., Kuruvilla, A., Vasantharaj, B., & John, J. K. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.3.494 · Cited by 96 · see citing works
Kinon, B., AHL, J. S. B., Liu‐Seifert, H., & Maguire, G. A. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.12.006 · Cited by 94 · see citing works
Hyperprolactinaemia and antipsychotic therapy in schizophrenia
Hummer, M., & Huber, J. C. (2004) · Current Medical Research and Opinion · doi:10.1185/030079903125002865 · Cited by 94 · see citing works
Kelly, D. L., & Conley, R. R. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.08.010 · Cited by 88 · see citing works
Bitter, I., Basson, B. R., & Dossenbach, M. R. K. (2004) · International Clinical Psychopharmacology · doi:10.1097/00004850-200501000-00004 · Cited by 72 · see citing works
Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression
Zisook, S., Nyer, M., Kasckow, J., Golshan, S., Lehman, D., & Montross, L. P. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.03.047 · Cited by 62 · see citing works
A 6-Month Prospective Observational Study on the Effects of Quetiapine on Sexual Functioning
Montejo, A. L., Rico‐Villademoros, F., Tafalla, M., & Majadas, S. (2005) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000186872.04984.56 · Cited by 48 · see citing works
Azorin, J., Strub, N., & Loft, H. (2005) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000177020.26311.a7 · Cited by 48 · see citing works
Reversal of Symptomatic Hyperprolactinemia by Aripiprazole
Wahl, R., & Ostroff, R. B. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.8.1542-a · Cited by 45 · see citing works
A new atypical antipsychotic: quetiapine-induced sexual dysfunctions
Atmaca, M., Kuloğlu, M. M., & Tezcan, E. (2004) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901260 · Cited by 42 · see citing works
Bitner, R. S., Nikkel, A. L., Otte, S. L., Martino, B. R., Barlow, E., Bhatia, P. A., Stewart, A. O., Brioni, J. D., Decker, M. W., & Moreland, R. B. (2005) · Neuropharmacology · doi:10.1016/j.neuropharm.2005.10.009 · Cited by 40 · see citing works
Jung, D.-U., Seo, Y.-S., Park, J.-H., Jeong, C.-Y., Conley, R. R., Kelly, D. L., & Shim, J.-C. (2005) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000186738.84276.9f · Cited by 25 · see citing works
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
“itself and to comorbid physical disorders, or be an adverse event of AP (520,524,525).”
BackgroundOrganic Causes of Erectile Dysfunction in Men Under 40
Ludwig, W. W., & Phillips, M. (2013) · Urologia Internationalis · doi:10.1159/000354931 · Cited by 2,156 · see citing works
Erectile Dysfunction in Young Men—A Review of the Prevalence and Risk Factors
Nguyen, H. M. T., Gabrielson, A. T., & Hellstrom, W. J. G. (2017) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2017.05.004 · Cited by 352 · see citing works
Safety and tolerability of antipsychotic polypharmacy
Gallego, J. A., Nielsen, J., Binder, M. D., Kane, J. M., & Correll, C. U. (2012) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2012.683523 · Cited by 205 · see citing works
“Sexual dysfunction can partly result from antipsychoticinduced hyperprolactinemia [39], but can also arise from sedation, histaminergic or adrenergic blockade, and/or cholinergic and serotonergic blockade [52].”
BackgroundManagement of sexual dysfunction due to antipsychotic drug therapy
Schmidt, H. M., Hagen, M., Kriston, L., Soares‐Weiser, K., Maayan, N., & Berner, M. M. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003546.pub3 · Cited by 92 · see citing works
Yang, Y., Song, Y., Lü, Y., Xu, Y., Liu, L., & Liu, X. (2019) · Andrologia · doi:10.1111/and.13395 · Cited by 86 · see citing works
“ED is usually related to psychiatric diseases, such as depression (Pastuszak, Badhiwala, Lipshultz, & Khera, 2013), schizophrenia (Malik, 2007) and psychiatric symp‐ toms (Corona et al., 2008).”
BackgroundVan Lankveld, J. J. D. M., Leusink, P., Van Diest, S., Gijs, L., & Slob, A. K. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01321.x · Cited by 84 · see citing works
Sexuality of people living with a mental illness: A collaborative challenge for mental health nurses
Quinn, C., & Browne, G. (2009) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2009.00598.x · Cited by 68 · see citing works
Sexual problems in a sample of the Turkish psychiatric population
Hariri, A. G., Karadağ, F., Tamar, D., Aksoy, U. M., & Tezcan, A. E. (2009) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.09.009 · Cited by 47 · see citing works
“In the last decade, and especially after the spread of HIV infection in the 1980s, a dramatic increase in the amount of attention given to various aspects of mentally unhealthy people's sexuality and high-risk sexual behaviors has been witnessed [4-10].”
BackgroundInfluentialSexual dysfunction among women with Schizophrenia—A cross sectional study from India
Simiyon, M., Chandra, P. S., & Desai, G. (2016) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2016.08.022 · Cited by 43 · see citing works
Montejo, A. L., & Rico‐Villademoros, F. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31818501a1 · Cited by 39 · see citing works
Novick, D., Haro, J. M., Perrin, E., Suarez, D. L., & Teixeira, J. M. (2009) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2009.03.003 · Cited by 39 · see citing works
“Sexual dysfunctions are common in patients with schizophrenia, affecting adherence to medication and quality of life, but have not beenwell studied (Malik, 2007).”
Souaiby, L., Kazour, F., Zoghbi, M., Khalil, R. B., & Richa, S. (2019) · Journal of Mental Health · doi:10.1080/09638237.2019.1581333 · Cited by 37 · see citing works
Sexual dysfunction and schizophrenia: psychiatrists' attitudes and training needs
Nnaji, R. N., & Friedman, T. (2008) · Psychiatric Bulletin · doi:10.1192/pb.bp.107.016162 · Cited by 33 · see citing works
“Illness variables include negative symptoms mediated by low libido, direct effects of psychosis and abnormalities in the limbic system (Baldwin & Mayers, 2003; Malik, 2007).”
BackgroundPsychotropics and sexual dysfunction
Bell, A., & Shamloul, R. M. (2013) · Editor-in-Chief s Voice List of Authors is an Important Element in a Scientific Publication · doi:10.5173/ceju.2013.04.art22 · Cited by 32 · see citing works
Sexual dysfunction in outpatients with schizophrenia in Turkey: a cross-sectional study.
Hocaoğlu, Ç., Çelik, F. H., Kandemir, G., Güveli, H., & Bahçeci, B. (2014) · Europe PMC (PubMed Central) · doi:10.11919/j.issn.1002-0829.214101 · Cited by 27 · see citing works
“The prevalence of sexual dysfunction among males and females with schizophrenia found in this study are comparable to those reported in other studies in Turkey([36-38]) and in other counties.([18,26,27,39,40]) Other studies have also reported substantial gender differences in the pattern of sexual dysfunction among pa…”
ResultThe impact of hyperprolactinaemia on sexual function in patients with psychosis
Smith, S. M. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088438 · Cited by 24 · see citing works
Mahmoud, A., Hayhurst, K. P., Drake, R., & Lewis, S. W. (2011) · Schizophrenia Research and Treatment · doi:10.1155/2011/596898 · Cited by 20 · see citing works
Ma, M.-C., Chao, J., Hung, J.-Y., Sung, S., & Chao, I.-H. C. (2018) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2018.01.008 · Cited by 19 · see citing works
Akkaya, C., Büşra, K. A. Y. A., Kotan, Z., Sarandöl, A., Ersoy, C., & Kırlı, S. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108091252 · Cited by 19 · see citing works
Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients with Bipolar Disorder
García‐Blanco, A., García‐Portilla, M. P., de la Fuente-Tomás, L., Batalla, M. G., Sánchez-Autet, M., Arranz, B., Safont, G., Arques, S., Livianos, L., & Sierra, P. (2020) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2020.01.032 · Cited by 18 · see citing works
The Schizophrenia Construct: Symptomatic Presentation
Arango, C., & Carpenter, W. T. (2010) · doi:10.1002/9781444327298.ch2 · Cited by 18 · see citing works
Sexual Side Effects of Antipsychotic Drugs
Bains, S., & Shah, A. A. (2012) · Advances in Pharmacoepidemiology & Drug Safety · doi:10.4172/2167-1052.1000109 · Cited by 14 · see citing works
Hatano, M., Kamei, H., Kato, A., Takeuchi, I., Hanya, M., Uno, J., Yamada, S., Fujita, K., & Iwata, N. (2017) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2017.15.2.132 · Cited by 14 · see citing works
Holoyda, B. J., McDermott, B. E., & Newman, W. J. (2017) · Journal of Forensic Sciences · doi:10.1111/1556-4029.13707 · Cited by 11 · see citing works
“that paraphilias in schizophrenia are relatively rare due to the natural progression of the disorder or due to the effects of exposure to antipsychotic medication (31).”
BackgroundOsasona, S. O., & Ehimigbai, M. (1970) · African Health Sciences · doi:10.4314/ahs.v19i4.18 · Cited by 11 · see citing works
Riedel, M. J., Spellmann, I., Schennach-Wolff, R., Obermeier, M., & Musil, R. (2010) · Quality of Life Research · doi:10.1007/s11136-010-9744-z · Cited by 11 · see citing works
Terevnikov, V., Stenberg, J., Tiihonen, J., Burkin, M. M., & Joffe, G. (2016) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2016.1233996 · Cited by 10 · see citing works
“Sexual dysfunction may be due to the disease itself, resulting from a number of physiological and endocrine abnormalities (2).”
BackgroundEdinoff, A. N., Nix, C. A., Fort, J. M., Kimble, J., Guedry, R., Thomas, G., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021) · Psychiatry International · doi:10.3390/psychiatryint3010003 · Cited by 9 · see citing works
“High prolactin levels interfere with the production of hormones such as estrogen and progesterone, which can cause menstrual irregularities [39].”
BackgroundBrand, E., Ratsch, A., Nagaraj, D., & Heffernan, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.975577 · Cited by 8 · see citing works
Collica, S. C., Pederzoli, F., & Bivalacqua, T. J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801299-4.00027-x · Cited by 7 · see citing works
Erectile Dysfunction in Young Adults: A Narrative Review
Safa, A. M., & Waked, C. (2025) · Cureus · doi:10.7759/cureus.89918 · Cited by 6 · see citing works
“The use of antiepileptic drugs and neuroleptics has also been linked to ED [41,42].”
Evaluation of health promotion programmes in severe mental illness: theory and practice
van Hasselt, F. M., Krabbe, P. F. M., Postma, M. J., & LOONEN, A. J. M. (2014) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1456 · Cited by 6 · see citing works
Yang, F.-W., & Liang, C. (2010) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2010.04.012 · Cited by 6 · see citing works
Mahmoud, A., Hayhurst, K. P., Drake, R., & Lewis, S. W. (2011) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2011.625122 · Cited by 5 · see citing works
Marital and Sexual Satisfaction among Patients with Schizophrenia
Kang, T.-W., Kang, G., Han, H. R., & Roh, S. (2012) · 신경정신의학 · doi:10.4306/jknpa.2012.51.5.263 · Cited by 5 · see citing works
Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients
Saad, A. E., Khalifa, D. A., El-Missiry, M., Elbatrawy, A. N., & Taha, S. (2015) · Middle East Current Psychiatry · doi:10.1097/01.xme.0000461673.36113.c8 · Cited by 4 · see citing works
Adverse Effects of Antipsychotics
Landry, P., Rousseau, A., & Skalli, L. (2010) · Wiley eBooks · doi:10.1002/9780470749180.ch17 · Cited by 5 · see citing works
Czyżewski, B. M., Czyzewska, J., Dorota, A., Dorota, M., Kozlowski, K., Żywiec, W., Milczarek, C., Mariankowska, A., & Koval, I. (2025) · Cureus · doi:10.7759/cureus.93259 · Cited by 3 · see citing works
“Additionally, many antipsychotics act on other receptors involved in sexual function, including serotonergic (5-HT2), adrenergic ( α 1), histaminergic (H1), and muscarinic (M1) receptors, contributing further to dysfunction [23, 45-47].”
Sexualité de la femme schizophrène en Tunisie : étude cas–témoins
Halouani, N., Ellouze, S., Aloulou, J., Charfeddine, F., Aribi, L., & Amami, O. (2018) · Sexologies · doi:10.1016/j.sexol.2017.12.003 · Cited by 3 · see citing works
Kazour, F., Obeïd, S., & Hallit, S. R. (2019) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12455 · Cited by 3 · see citing works
Frequency of sexual dysfunction in outpatients with severe mental illness in Greece
Angelaki, M., Alexiou, E., Igoumenou, A., & Alevizopoulos, G. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1227218 · Cited by 2 · see citing works
Syndrome métabolique et antipsychotiques atypiques : recommandations et prise en charge clinique
Solida, A., Choong, E., Lechaire, C., Eap, C. B., & Conus, P. (2011) · L information psychiatrique · doi:10.3917/inpsy.8709.0715 · Cited by 2 · see citing works
Scherer, R. A. (2007) · Indiana Health Law Review · doi:10.18060/16516 · Cited by 2 · see citing works
Syndrome métabolique et antipsychotiques atypiques : recommandations et prise en charge clinique
Solida, A., Choong, E., Lechaire, C., Eap, C. B., & Conus, P. (2011) · L information psychiatrique · doi:10.1684/ipe.2011.0853 · Cited by 3 · see citing works
Simiyon, M., Chandra, P. S., & Desai, G. (2019) · Journal of Psychosexual Health · doi:10.1177/2631831819894773 · Cited by 1 · see citing works
Sexual knowledge of Queensland forensic mental health patients: A cross-sectional quantitative study
Brand, E., Tham, C., Ratsch, A., & Heffernan, E. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1160277 · Cited by 1 · see citing works
“How does a woman know that she is pregnant? (10 indications) 1 2 3 4 5 6 12 20 4 1 1 2 3 4 5 0 2 3 2 0 1 2 3 4 5 6 (12)* 14 (28)* 23 (46)* 6 (12)* 1 (2)*”
BackgroundInfluentialShettima, F. B., Wakil, M. A., Sheikh, T. L., Rabbebe, I. B., Abdulaziz, M., Jidda, S. M., & Dahiru, A. M. C. (2024) · PubMed Central · doi:10.60787/nmj-64-5-311 · Cited by 1 · see citing works
(2019) · Psychiatry and Clinical Psychopharmacology · doi:10.1080/24750573.2019.1606883 · Cited by 1 · see citing works
Konarzewska, B., Szulc, A., & Waszkiewicz, N. (2008)
Maj, M., Ïðåçèäåíò, È., Tasman, A., & Herrman, H. (2011)
(2008) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.6.2.foc197
Influence of Antipsychotic Agents on the Sexuality of Patients Diagnosed with Schizophrenia
Jaballah, F., Ferhi, M., Zgueb, Y., Oumaya, H., Bouzid, R., & Mannai, J. (2023) · Current Therapeutic Research · doi:10.1016/j.curtheres.2023.100722
“A review of the literature regarding sexual dysfunction in people with SCZ developed by Malik 21 in 2007 highlighted that some of the articles reviewed point out that AAPs seem to have a better tolerance for sexuality than TAPs.”
BackgroundMuraoka, H., Momohara, S., & Inada, K. (2026) · Psychiatry Research Case Reports · doi:10.1016/j.psycr.2026.100346
- Authors
- Malik, P.
- Venue
- Current Opinion in Psychiatry
- Published
- 2007-03
- Volume
- 20
- Issue
- 2
- Pages
- 138-142
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W1992459633
- Cited by
- 54
- References
- 22
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- sexual dysfunction, schizophrenia, antipsychotic adverse effects, atypical antipsychotics, prolactin elevation, amisulpride, risperidone, quality of life, treatment options
- MeSH terms
- Cross-Sectional Studies, Female, Humans, Erectile Dysfunction, Libido, Male, Orgasm, Product Surveillance, Postmarketing, Risk Factors, Schizophrenia, Sexual Dysfunction, Physiological, Antipsychotic Agents, Comorbidity
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