Frequency of Sexual Dysfunction and Other Reproductive Side-effects in Patients with Schizophrenia Treated with Risperidone, Olanzapine, Quetiapine, or Haloperidol: The Results of the EIRE Study

• Published in: Journal of sex & marital therapy 2003-03, Vol.29 (2), p.125-147
• Main Authors: BOBES, J., GARC A-PORTILLA, M. P., REJAS, J., HERN NDEZ, G., GARCIA-GARCIA, M., RICO-VILLADEMOROS, F., PORRAS, A.
• Format: Article
• Language: English
• Subjects: Adult; Amenorrhea - chemically induced; Amenorrhea - epidemiology; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Benzodiazepines; Biological and medical sciences; Dibenzothiazepines - adverse effects; Dibenzothiazepines - therapeutic use; Female; Galactorrhea - chemically induced; Galactorrhea - epidemiology; Gynecomastia - chemically induced; Gynecomastia - epidemiology; Haloperidol - adverse effects; Haloperidol - therapeutic use; Humans; Incidence; Male; Medical sciences; Neuropharmacology; Pharmacology. Drug treatments; Pirenzepine - adverse effects; Pirenzepine - analogs & derivatives; Pirenzepine - therapeutic use; Prevalence; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Quetiapine Fumarate; Risperidone - adverse effects; Risperidone - therapeutic use; Schizophrenia - drug therapy; Sexual Dysfunction, Physiological - chemically induced; Sexual Dysfunction, Physiological - epidemiology
• ISSN: 0092-623X; 1521-0715
• DOI: 10.1080/713847170

Atypical antipsychotics seem to differ mainly in their tolerability profile. The aim of this cross-sectional study, the Estudio de Investigaci n de Resultados en Esquizofrenia (Outcomes Research Study in Schizophrenia; EIRE study), was to assess in a clinical setting the frequency of several side-effects related to haloperidol, risperidone, olanzapine, and quetiapine. This article addresses sexual dysfunction and other reproductive side-effects (gynecomastia, menorrhage, amenorrhea, and galactorrhea). We recruited outpatients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria and who had received a single antipsychotic (risperidone, olanzapine, quetiapine, or haloperidol) for at least 4 weeks. During a single visit, we collected data, including demographic and clinical characteristics, current antipsychotic and concomitant treatment, and adverse effects listed in a modified version of the UKU Scale. We used a Chi-squared test to determine pairs comparisons of the frequency of adverse reactions between treatments. To estimate risk of a given adverse reaction with a given treatment, we used a logistic regression method. We assessed 636 evaluable patients out of 669 recruited. Frequency of sexual dysfunction was high with haloperidol (38.1%) and also with olanzapine (35.3%), quetiapine (18.2%), and risperidone (43.2%). We found the frequency of other reproductive side-effects to be relatively low with all four drugs: haloperidol (6.9%), olanzapine (6.4%), quetiapine (2.7%), and risperidone (11.7%). Sexual dysfunction appeared to be dose-related with haloperidol, risperidone, and olanzapine. Risperidone and olanzapine showed a higher risk of sexual dysfunction and other reproductive sideeffects than haloperidol. Quetiapine showed a lower risk of sexual dysfunction during short-term treatment ( 12 weeks) are lacking. Our results suggest that none of the atypical antipsychotics that we studied significantly improved sexual dysfunction and other reproductive side-effects of the conventional antipsychotic, haloperidol, in stabilized patients during long-term treatment. Quetiapine appears to improve this profile during short-term treatment; however, longterm data, with larger samples, are required with this latter drug.