Antipsychotic-Induced Sexual Dysfunction and the Strength of the Evidence

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Sir: Olfson and colleagues¹ conclude from a cross-sectionalstudy in 139 outpatients with schizophrenia that sexual dysfunctionis common in men who are treated with olanzapine,risperidone, quetiapine, or haloperidol and is associated withdiminished quality of life and decreased occurrence of romanticrelationships.

Their results concerning rates of sexual dysfunction aresomewhat surprising both because of the high rates encounteredwith olanzapine (54.1%) and quetiapine (50%) and becauseof the lack of differences in impact on sexual functioningamong the antipsychotics under study. We agree with the studylimitations mentioned by the authors: causality based solely onpatients’ attribution, lack of baseline assessment of sexual functioning,and lack of power.