Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T05:41:52.425Z Has data issue: false hasContentIssue false
  • English
  • Français

Disfunción sexual en pacientes con esquizofrenia tratados con antipsicóticos

Published online by Cambridge University Press:  12 May 2020

Alp Üçok ,
Cern Incesu ,
Tamer Aker  and
Şahap Erkoç
Alp Üçok
Affiliation:
Universidad de Estambul, Facultad de Medicina de Estambul, Departamento de Psiquiatría, Millet Street, Capa 34390, Estambul, Turquía
Cern Incesu
Affiliation:
Hospital Acibadem, Departamento de Psiquiatría, Estambul, Turquía
Tamer Aker
Affiliation:
Universidad Kocaeli, Facultad de Medicina Kocaeli, Izmit, Turquía
Şahap Erkoç
Affiliation:
Hospital Estatal para los Trastornos Mentales Bakirköy, Estambul, Turquía
Get access

Resumen

Objetivo

El objetivo de este estudio fue determinar la prevalencia de disfunción sexual en pacientes con esquizofrenia tratados con antipsicóticos e investigar el efecto de varios parámetros sobre la disfunción sexual.

Método

Se seleccionaron para el estudio 827 pacientes estabilizados que estaban siendo tratados de forma ambulatoria y que cumplieron los criterios de esquizofrenia del DSM-IV. Se aplicaron la Escala de Experiencias Sexuales de Arizona (ASEX) y la subescala de función sexual de la Escala de Puntuación de Efectos Secundarios UKU en una sola entrevista.

Resultados

En total, el 52,6% de los pacientes tenía disfunción sexual, el 54,2% refirió poco deseo sexual y el 41,7%, dificultad para experimentar un orgasmo. Tenían disfunción eréctil y problemas de eyaculación el 48,1% y el 64,2% de los hombres, respectivamente; el 24,9% de las mujeres tenía amenorrea. Se encontró una correlación entre la puntuación ASEX y la gravedad de la enfermedad (p = 0,02). Los pacientes que fumaban tenían puntuaciones ASEX más altas (p = 0,01). Los hombres que recibían monoterapia atípica tuvieron unas puntuaciones ASEX más bajas que los que recibían una combinación de antipsicóticos atípicos y convencionales (p = 0,017). Los pacientes que recibían tratamiento combinado tenían más problemas de eyaculación que el grupo que recibía fármacos atípicos (p = 0,001). El deseo sexual bajo era más frecuente en mujeres que tomaban fármacos convencionales que en los que tomaban fármacos atípicos (p = 0,004). En los análisis de regresión lineal, ASEX varió significativamente y de forma independiente por la gravedad de la enfermedad sólo en hombres (p = 0,005).

Conclusión

Nuestros resultados demuestran que en pacientes con esquizofrenia que toman antipsicóticos es muy frecuente la disfunción sexual. 2007 Elsevier Masson SAS. Reservados todos los derechos.

Keywords

EsquizofreniaDisfunción sexualAntipsicóticos típicosAntipsicóticos atípicosASEX
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 14 , Issue 8 , November 2007 , pp. 393 - 399
Copyright
Copyright © European Psychiatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Aizenberg, DModai, ILanda, AGil-Ad, IWeizman, AComparison of sexual dysfunction in mole schizophrenic patients maintained on treatment with classical antipsychotics versus clozapine. J Clin Psychiatry 2001;62:541–4.CrossRefGoogle Scholar
Aizenberg, DZemishlany, ZDorfman-Etrog, PWeizman, ASexual dysfunction in male schizophrenic patients. J Clin Psychiatry 1995;56:137–41.Google ScholarPubMed
Alptekin, KErkoc, SGogus, AKKultur, SMete, LUcok, Aet al. Disability in schizophrenia: clinical correlates and prediction over 1-year follow-up. Psychiatry Res 2005;135:103–11.CrossRefGoogle ScholarPubMed
Atmaca, MKuloglu, MTezcan, EA new atypical antipsychotic: quetiapine-induced sexual dysfunctions. Int J Impot Res 2005;17:201–3.CrossRefGoogle ScholarPubMed
Balon, RSexual function and dysfunction during treatment with psychotropic medications. J Clin Psychiatry 2005;66:1488–99.CrossRefGoogle ScholarPubMed
Bobes, JGarc A-Portilla, MPRejas, JHernandez, GGarcia-Garcia, MRico-Villademoros, Fet al. 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. J Sex Marital Ther 2003;29:125–47.CrossRefGoogle ScholarPubMed
Byerly, MJLescouflair, EWeber, MTBugno, RMFisher, RCarmody, Tet al. An open-label trial of quetiapine for antipsychoticinduced sexual dysfunction. J Sex Marital Ther 2004;30:325–32.CrossRefGoogle Scholar
Byerly, MJNakonezny, PABettcher, BMCarmody, TFisher, RRush, AJSexual dysfunction associated with second-generation antipsychotics in outpatients with schizophrenia or schizoaffective disorder: an empirical evaluation of olanzapine, risperidone, and quetiapine. Schizophr Res 2006;86:244–50.CrossRefGoogle ScholarPubMed
Byerly, MJNakonezny, PAFisher, RMagouirk, BRush, AJAn empirical evaluation of the Arizona sexual experience scale and a simple oneitem screening test for assessing antipsychotic-related sexual dysfunction in outpatients with schizophrenia and schizoaffective disorder. Schizophr Res 2006;81:311–6.CrossRefGoogle Scholar
Cutler, AJSexual dysfunction and antipsychotic treatment. Psychoneuroendocrinology 2003; 1 (Suppl): 69–82.CrossRefGoogle Scholar
Dossenbach, MDyachkova, YPirildar, SAnders, MKhalil, AAraszkiewicz, Aet al. Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12 –month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. Eur Psychiatry 2006;21:251–8.CrossRefGoogle ScholarPubMed
Dossenbach, MErol, Ael Mahfoud, Kessaci MShaheen, MOSunbol, MMBoland, Jet al. IC-SOHO Study Group Effectiveness of antipsychotic treatments for schizophrenia: interim 6-month analysis from a prospective observational study (IC-SOHO) comparing olanzapine, quetiapine, risperidone, and haloperidol. J Clin Psychiatry 2004;65:312–21.CrossRefGoogle Scholar
Gades, NMNehra, AJacobson, DJMcGree, MEGirman, CJRhodes, Tet al. Association between smoking and erectile dysfunction: a population-based study. Am J Epidemiol 2005;161:346–51.CrossRefGoogle ScholarPubMed
Goodnick, PJRodriguez, LSantana, OAntipsychotics: impact on prolactin levels. Expert Opin Pharmacoter 2002;3:1381–91.CrossRefGoogle ScholarPubMed
Guy, Wed). Clinical global impressions (CGI). In: ECDEU assessment manual for psychopharmacology. US Department of Health and Human Services, Public Health Service, Alcohol Drug Abuse and Mental Health Administration, NIMH Psychopharmacology Research branch; 1976. p. 218-22.Google Scholar
Hummer, MKemmler, GKurz, MKurzthaler, IOberbauer, HFleischhacker, WWSexual disturbances during clozapine and haloperidol treatment for schizophrenia. Am J Psychiatry 1999;156:631–3.Google Scholar
Jayaram, MBHosalli, PRisperidone versus olanzapine for schizophrenia. Cochrane Database Syst Rev 2005;18(2). CD005237.Google Scholar
Kelly, DLConley, RRSexuality and schizophrenia: a review. Schizophr Bull 2004;30:767–79.CrossRefGoogle ScholarPubMed
Kim, KSPae, CUChae, JHBahk, WMJun, TYKim, DJet al. Effects of olanzapine on prolactin levels of female patients with schizophrenia treated with risperidone. J Clin Psychiatry 2002;63:408–13.CrossRefGoogle ScholarPubMed
Kleinberg, DLDavis, JMde Coster, RVan Baelen, BBrecher, MProlactin levels and adverse events in patients treated with risperidone. J Clin Psychopharmacol 1999;19:57–61.CrossRefGoogle ScholarPubMed
Knegtering, HBoks, MBlijd, CCastelein, Svan den Bosch, RJWiersma, DA randomized open-label comparison of the impact of olanzapine versus risperidone on sexual functioning. J Sex Marital Ther 2006;32:315–26.CrossRefGoogle ScholarPubMed
Knegtering, RCastelein, SBons, HVan Der Linde, JBruggeman, RKluiter, Het al. A randomized open-label study of the impact of quetiapine versus risperidone on sexual functioning. J Clin Psychopharmacol 2004;24:56–61.CrossRefGoogle ScholarPubMed
Kockott, GPfeiffer, WSexual disorders in nonacute psychiatric outpatients. Compr Psychiatry 1996;37:56–61.CrossRefGoogle ScholarPubMed
Lambert, MConus, PEide, PMass, RKarow, AMoritz, Set al. Impact of present and post antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry 2004;19:415–22.CrossRefGoogle Scholar
Lambert, MHaro, JMNovick, DEdgell, ETKennedy, LRatcliffe, Met al. Olanzapine vs other antipsychotics in actual out-patient settings: six months tolerability results from the European Schizophrenia Outpatient Health Outcomes study. Acta Psychiatr Scand 2005;111:232–43.CrossRefGoogle Scholar
Lingjaerde, OAhlfors, UGBech, PDencker, SJElgen, KThe UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand 1987;334(Suppl.):l—100.Google Scholar
Macdonald, SHalliday, JMacEwan, TSharkey, VFarrington, SWall, Set al. Nithsdale Schizophrenia Surveys 24: sexual dysfunction. Case— control study. Br J Psychiatry 2003;182:50–6.CrossRefGoogle ScholarPubMed
McGahuey, CAGelenberg, AJLankes, JAMoreno, FADelgado, PLMcKnight, KMet al. The Arizona Sexual Experience Scale (ASEX). Reliability and validity. J Sex Marital Ther 2000;26:25–40.Google ScholarPubMed
Montejo Gonzalez, ALRico-Villademoros, FTafalla, MMajadas SSpanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. A 6-month prospective observational study on the effects of quetiapine on sexual functioning. J Clin Psychopharmacol 2005;25:533–8.CrossRefGoogle ScholarPubMed
Naber, DKarow, ALambert, MSubjective well-being under the neuroleptic treatment and its relevance for compliance. Acta Psychiatr Scand Suppl 2005;427:29–34.CrossRefGoogle Scholar
Olfson, MUttaro, TCarson, WHTafesse, EMale sexual dysfunction and quality of life in schizophrenia. J Clin Psychiatry 2005;66:331–8.CrossRefGoogle Scholar
Perkins, DOPredictors of noncompliance in patients with schizophrenia. J Clin Psychiatry 2002;63:1121–8.CrossRefGoogle ScholarPubMed
Salokangas, RKHonkonen, TStengard, EKoivisto, AMHietala, JCigarette smoking in long-term schizophrenia. Eur Psychiatry 2006;2:219–23.CrossRefGoogle Scholar
Smith, SMO'Keane, V, Murray, RSexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry 2002;181:49–55.CrossRefGoogle ScholarPubMed
Stimmel, GLGutierrez, MA. Sexual dysfunction and psychotropic medications. CNS Spectr 2006;11(8 Suppl. 9):24–30.CrossRefGoogle ScholarPubMed
Teusch, LScherbaum, NBohme, HBender, SEschmann-Mehl, GGastpar, MDifferent patterns of sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. Results of an investigation by semistructured interview of schizophrenic and neurotic patients and methadone-substituted opiate addicts. Pharmacopsychiatry 1995;28:84–92.CrossRefGoogle ScholarPubMed
Ucok, APolat, ABozkurt, OMeteris, HCigarette smoking among patients with schizophrenia and bipolar disorders. Psychiatry Clin Neurosci 2004;58:434–7.CrossRefGoogle ScholarPubMed
Volavka, JCzobor, PCooper, TBSheitman, BLindenmayer, JPCitrome, Let al. Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol. J Clin Psychiatry 2004;65:57–61.CrossRefGoogle ScholarPubMed
Zhong, KXSweitzer, DEHamer, RMLieberman, JAComparison of quetiapine and risperidone in the treatment of schizophrenia: a randomized, double-blind, flexible-dose, 8-week study. J Clin Psychiatry 2006;67:1093–103.CrossRefGoogle ScholarPubMed