Reversal by bethanechol of sexual dysfunction caused by anticholinergic antidepressants

The anticholinergic properties of currently available antidepressants sometimes cause sexual dysfunction. Bethanechol, a cholinergic drug, was found to give total relief of impotence in two men and of anorgasmy in one woman; none of the subjects suffered side effects.

Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients

A random sample of 55 schizophrenic outpatients, 26 men and 29 women, treated with neuroleptics was selected from our long term follow-up clinic. The patients rated their current sexual functioning on specially designed scales. Fifty-four per cent of male and 30 per cent of female patients reported impaired sexual functioning during neuroleptic treatment. Ninety-one per cent of female patients reported changes in menstruation. Partial correlation coefficients were calculated between sexual dysfunction score and plasma prolactin level adjusting for age. Sexual dysfunction was found to be associated with high plasma prolactin levels in male patients but not in female patients. High prolactin tended also to be associated with menstrual disturbances. Antiparkinsonian medication was not found to be correlated with either sexual dysfunction or menstrual disorder score.

Antipsychotic drug therapy and sexual dysfunction in men

The authors review the literature on male sexual dysfunction associated with antipsychotic drug treatment. Erectile and ejaculatory disturbances have been most frequently reported. Changes in libido have also been reported, but the effects of these drugs on sexual drive have apparently not been systematically studied. Fortunately, most types of sexual dysfunction associated with antipsychotic drugs appear to be medically benign and reversible with drug discontinuation. An exception is priapism, which necessitates prompt urological consultation and may require surgical intervention.

Sexual dysfunction and clomipramine

Three cases of orgasmic inhibition by clomipramine are reported, one in a male and two in females. All were depressed patients with obsessive-compulsive features. Orgasmic dysfunction manifested shortly after beginning clomipramine therapy despite a return of libido as the depression lifted. Two of these patients switched to desipramine which led to a resolution of sexual dysfunction while maintaining the patients depression free. The third patient manipulated dosage times to diminish the orgastic problem. Strong anticholinergic and/or anti-adrenergic properties of clomipramine are suspected to underlie the development of this problem.

Cytotoxic-induced ovarian failure in Hodgkin's disease. II. Effects on sexual function

Chemotheraphy for Hodgkin's disease produces ovarian failure in young women. The consequences of this are emotional distress, sexual dysfunction, and the disruption of families and friendships. These previously unappreciated side effects of cytotoxic therapy had developed in 25 of 41 patients, among whom we conducted a retrospective study.