In psychotic disorders, early intevention with antipsychotic medications increase the likelihood of favourable long-term course. However, the farmacologic management especially with first-generation (typical) antipsychotic medications is complicated by a high rate of adverse effects including sexual dysfunctions, mainly through their potential to induce hyperprolactinemia. Prolactine related symptoms include decreased sexual desire, erectile dysfunction, ejaculatory dysfunction, menstrual irregularities, amenorrhea, dysmenorrhea, gynecomastia. However, with the advent of second generation (atypical) antipsychotics, patients receiving these drugs showed less side effects such as sexual dysfunctions and higher level of adherence to treatment. The aim of this review is to describe the epidemiological and clinical features of sexual dysfunctions related to the first and second generation antipsycotic drugs, and the strategies for managing this problem, including pharmacological and psychosocial approaches.
Keywords: Sexual dysfunction; antipsychotics; schizophrenia; dopamine; prolactin, quality of life.