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Sexual dysfunction related to opioid maintenance treatment with methadone and levomethadone Background: Sexual dysfunction is a common side effect in opioid maintenance treatment (OMT). Apart from methadone, in Germany levomethadone is the most often prescribed substance for OMT. Despite the high clinical relevance of these side effects, to our knowledge no study has investigated the influence of methadone compared to that of levomethadone on sexual function. Objectives: To collect data on sexual dysfunction with a standardized questionnaire and self-evaluation. Material and Methods: We conducted a study with chronically affected opioid dependent male patients currently receiving OMT with methadone and levomethadone in Berlin. We used the International Index of Erectile Function (IIEF) as well as self-ratings. Results: 66 patients took part, 30 (45.5%) in the methadone, 36 (54.5%) in the levomethadone group. Erectile dysfunction occurred significantly more often in the methadone group (p = .029). Patients reporting sexual desire (N = 40, 71.4%) in self-ratings received a significantly higher dosing of OMT (p = .014, 125 mg ± 45.3 mg vs. 93.3 mg ± 24.7 mg). Conclusions: Our study hints to a superiority of levomethadone over methadone concerning self-reported erectile function. If sexual dysfunction is present in a subject being treated with OMT, a switch to levomethadone or an overall reduction of the dosage could be helpful. [ABSTRACT FROM AUTHOR]