Engel Johanna, Jeridi Lamin, Auerbach Lilly, Zolk Oliver, Greiner Timo, Heinze Martin, Buspavanich Pichit, Schneider Michael
University Clinic for Psychiatry and Psychotherapy, Brandenburg Medical School Immanuel Klinik Rüdersdorf, Seebad 82/83, Rüdersdorf bei Berlin, 15562, Rüdersdorf, Germany.
Institute of Clinical Pharmacology of the Brandenburg Medical School, Brandenburg Medical School Immanuel Klinik Rüdersdorf, Seebad 82/83, Rüdersdorf bei Berlin, 15562, Rüdersdorf, Germany.
Naunyn Schmiedebergs Arch Pharmacol. 2025 Jul;398(7):8419-8430. doi: 10.1007/s00210-024-03763-8. Epub 2025 Jan 11.
Sexual dysfunctions (SD) are common and debilitating side effects of antipsychotics. The current study analyzes the occurrence of antipsychotic-related SD using data from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). FAERS was queried for sexual dysfunction adverse events (encoded by 35 different MedDRA preferred terms) secondary to amisulpride, aripiprazole, chlorprothixene, clozapine, haloperidol, loxapine, olanzapine, pipamperone, quetiapine, risperidone, and ziprasidone from 2000 to 2023. Disproportionality signal analysis was performed by calculating the reporting odds ratio (ROR) with its 95% confidence interval (CI). During the observation period, 9203 cases of SD were reported in association with the antipsychotic drug use. Men reported these dysfunctions more frequently (68.4% of all cases) than women. Ziprasidone had the highest ROR for sexual dysfunction in FAERS, at , followed by aripirazole for sexual dysfunction . In general, aripiprazole, olanzapine, risperidone, ziprasidone, and quetiapine had higher risk signals across multiple adverse events (AEs), whereas chlorprothixene, loxapine, and amisulpride showed lower risk signals. The pathogenesis of SD does not appear to be limited to specific pathomechanisms and therefore not to specific substances. The differing report distributions by sex and the impact of polypharmacy on the symptoms warrant further investigations.
性功能障碍（SD）是抗精神病药物常见且使人虚弱的副作用。本研究利用美国食品药品监督管理局（FDA）不良事件报告系统（FAERS）的数据，分析与抗精神病药物相关的性功能障碍的发生情况。在FAERS中查询了2000年至2023年期间，氨磺必利、阿立哌唑、氯普噻吨、氯氮平、氟哌啶醇、洛沙平、奥氮平、匹泮哌隆、喹硫平、利培酮和齐拉西酮所致的性功能障碍不良事件（由35个不同的MedDRA首选术语编码）。通过计算报告比值比（ROR）及其95%置信区间（CI）进行不成比例信号分析。在观察期内，报告了9203例与使用抗精神病药物相关的性功能障碍病例。男性报告这些功能障碍的频率（占所有病例的68.4%）高于女性。在FAERS中，齐拉西酮的性功能障碍ROR最高，为 ，其次是阿立哌唑的性功能障碍 。总体而言，阿立哌唑、奥氮平、利培酮、齐拉西酮和喹硫平在多种不良事件（AE）中具有较高的风险信号，而氯普噻吨、洛沙平和氨磺必利的风险信号较低。性功能障碍的发病机制似乎不限于特定的病理机制，因此也不限于特定物质。按性别划分的不同报告分布以及联合用药对症状的影响值得进一步研究。
