Impact of Psychotropic Medications on Sexual Functioning

In the previous chapters, the complexities of sexual problems accompanying different mental disorders have been comprehensively described. This chapter deals with the impact of psychotropic medications on sexual functioning. It encompasses biochemical mechanisms that modulate both mental state and sexual response through neurotransmitters and neurohormones, as well as indirect influences through their impact on psychomotor and cardiometabolic profile. Treatment-emergent changes in body image and sexual functioning can have a profound effect on self-esteem and intimate relationships. Treatment-related sexual side effects are underreported and poorly recognized in clinical practice of mental health professionals; although, they have a great impact on poor adherence to medication and related clinical outcomes. As sexual satisfaction is one of the most important determinants influencing well-being and quality of life, clinicians should give more attention to it and actively ask their patients about sexual functioning and adapt the medication accordingly. A comprehensive overview and practical recommendations on clinical investigation and management of psychotropic medication-related sexual side effects are presented in the second part of the chapter.