Sexual side effects of antipsychotic drugs in schizophrenia

Sexual side effects of antipsychotic drugs in schizophrenia: a systematic review with single-arm, pairwise, and network meta-analyses of randomized controlled trials and non-randomized studies

Sexual side effects of antipsychotics are common yet underreported among patients with schizophrenia, affecting 30–80% of treated individuals. These side effects are related to the three phases of the sexual response cycle (i.e., desire, arousal, and orgasm), which include decreased libido, erectile dysfunction, and anorgasmia. Sometimes side effects related to breast and menstrual disorders (e.g., galactorrhea and amenorrhea) are also considered sexual side effects of antipsychotics. Nevertheless, they can severely impact treatment adherence and social interactions in individuals with schizophrenia, but comprehensive comparative evidence characterizing the risk profiles of different antipsychotics is lacking.

This study aims to address this gap using single-arm, pairwise, and network meta-analyses that integrate data from both randomized-controlled trials (RCTs) and non-randomized studies (NRS). Specifically, we aim to estimate the absolute frequencies of sexual side effects among different antipsychotics using a single-arm meta-analysis, and will estimate the relative effects of different antipsychotics by performing a combined network meta-analysis of RCTs and NRS. This study will provide vital insights into the sexual side effects of antipsychotics by combining evidence from clinical trials and real-world practice, facilitating better decision-making in prescribing the optimal antipsychotic for individuals with schizophrenia.

The project is funded by the Federal Ministry for Education and Research (BMBF, grant number 01KG2317).

The protocol of the project was published in F1000 and registered with PROSPERO (CRD42024510190).

Contact person: Dr. David Kim

Supervisor: Prof. Dr. Stefan Leucht