(083) PROSPECTIVE STUDY OF SEXUAL DYSFUNCTION RELATED TO PSYCHOPHARMACOLOGICAL DRUGS IN PATIENTS WITH AFFECTIVE DISORDERS
Authors: Elkowessny D , Molokheya T , Rady A , Alkhouly O , Unterecker S 
Published: December 2024

Abstract

Introduction
Sexual dysfunctions are common among psychiatric patients, and they may be influenced by a variety of social, environmental, and cultural factors, as well as a psychopathology-pharmacotherapy interaction. Medical professionals underestimate the prevalence of sexual dysfunction among psychiatric patients on antidepressants, which may result in noncompliance with treatment. The quantification and interpretation of drug concentrations in blood is known as therapeutic drug monitoring (TDM), and it is a useful tool for optimizing pharmacotherapy.

Objective
The aim of the study is to investigate the association between the dosage and serum blood concentration of 6 Psychopharmacological medications including Amitriptyline, venlafaxine, Bupropion, Mirtazapine, Quetiapine, Risperidone and Sertraline and their related sexual dysfunctions among the patients suffering from Affective Disorders.

Methods
Patients suffering from a depressive episode of any affective disorder were recruited in the period from the beginning of September 2019 to the end of July 2020. They were admitted as inpatients to the department of psychiatry of a university hospital. A correlation study was designed to evaluate the link between sexual dysfunction caused by the psychopharmacological drugs and their doses together with their serum concentration. Severity of sexual side effects were assessed at admission and then biweekly by trained raters using the Arizona Sexual Experience Scale (ASEX). Therapeutic drug monitoring (TDM) was assessed by measuring the plasma serum concentrations of the psychopharmacological drugs at admission and then biweekly by trained laboratory personnel.

Results
50 patients were included in the study in the 1st week and 44 patients (88%) continued to the end of the 7th week. 37 patients (74%). showed sexual dysfunction according to the ASEX scale in the 1st week and 28 (63.6%) patients continued to have SD by the end of the 7th week. There were only statistically significant correlations in only 3 psychopharmacological drugs. In Amitriptyline, there was a statistically significant negative correlation (r = 0.77, P = 0.043) in the 5th and the 7th week (r = 0.82, P = 0.024) respectively. Concerning Venlafaxine, there was a statistically significant positive correlation (r = 0.56, P = 0.048) in the 3rd week only. While Quetiapine showed a weak positive significant correlation (r = 0.53, P = 0.028) by the 3rd week.

Conclusions
From these results, we concluded that exposure and response to psychotropic medication is better correlated with serum levels of medication than with total daily dose. Therapeutic drug monitoring (TDM) is advised for patients who have adverse effects when using psycho-pharmacotherapy at have recommended doses; hence, it may be helpful for patients who complain of sexual dysfunction brought on by antidepressants.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Alexandria University.