Amantadine in the Treatment of Sexual Inactivity in Schizophrenia Patients Taking Atypical Antipsychotics-The Pilot Case Series Study.

Marek Krzystanek,Artur Pałasz,Katarzyna Skałacka,Ewa Martyniak,Beata Trędzbor,Anna Warchala

doi:10.3390/ph14100947

Abstract

Sexual dysfunctions in people with schizophrenia are more severe than in the general population and are an important element in the treatment of schizophrenia. The mechanism of sexual dysfunction in patients treated for schizophrenia may be related to the side effects of antipsychotic drugs (hyperprolactinemia, suppression of the reward system), but it may also be related to the pathogenesis of schizophrenia itself. The aim of the study was to present the possibility of using amantadine in the treatment of sexual dysfunction in schizophrenia without the concomitant hyperprolactinemia. In an open and naturalistic case series study, five men treated for schizophrenia in a stable mental state were described. All patients reported a prolonged lack of sexual desire and sexual activity prior to treatment with amantadine. After exclusion of hyperprolactinemia, patients received amantadine 100 mg in the evening. Sexual dysfunction was assessed using subscales of the 14-point Short Form of the Changes in Sexual Functioning Questionnaire (CSFQ-14). On subsequent visits after 1, 2 and 3 months of administration of amantadine, an improvement in sexual functioning was observed in all patients. Although this is only the preliminary report, amantadine may become a new indication for the treatment of sexual dysfunction in schizophrenia patients.

Highlights

Antipsychotic drugs can cause sexual dysfunction by increasing the level of prolactin, on the other hand, the antidopaminergic mechanism of action of antipsychotic drugs itself may contribute to suppressing the reward system and reducing sexual desire
In the described 3-month observation period, a constant improvement in sexual function was observed, the largest in terms of desire and orgasm. This suggests that people with schizophrenia treated with antipsychotic drugs can achieve greater improvements in sexual function along with the duration of treatment with amantadine
In patients treated for schizophrenia, endogenous sexual disorders and drug-induced disorders may overlap, and we have probably studied this group of patients

Summary

Introduction

The prevalence of sexual dysfunctions in patients with schizophrenia treated with antipsychotics, depending on the study, concerns. 44% [3], 50% [4] or 65% of patients [5], and even 82% in the group of men [6] For these reasons, the treatment of sexual dysfunctions is a clinically important element in the comprehensive treatment of schizophrenia. The pathogenesis of sexual dysfunction in schizophrenia is complex. They may be an adverse effect of antipsychotic drugs, but they may be endogenous, related to the disease itself [7]. The mechanism of sexual dysfunction associated with the suppression of the mesocortical dopaminergic pathways is more likely in people treated with atypical antipsychotics, associated with a lower risk of hyperprolactinemia [8]

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