Prevalence of Sexual dysfunction among psychosis patient is very high. Impaired sexual functioning is an inherent component of psychosis. Antipsychotics are first line treatment of psychosis. These drugs got adverse SD , leading to non compliance and  impairment of  their quality of life.


Pub med search was made, using key words schizophrenia   ,antipsychotic, sexual dysfunction.


Sexual dysfunction among psychotics is twofold higher than normal population . 45 to 80 % patient on  antipsychotic have SD. Sexual dysfunction among male patient under age of 50 in first episode of schizophrenia was  56 vs 6% in control. Higher proclactin is found in drug naive patient of schizophrenia patient vs control  12.5 ng/ml in patient vs 8.6nf/mg. Lower T3 is reported among these patient .   Loss of libido In olanzapine treated  is 17.8 % resperidone 35.5  %   and in haloperidole 38.7%   . There is relationship between longer duration of untreated psychosis and sexual dysfunction.


Among the  psychosis patients  It is presumed that Sexual  functions are impaired due to positive and negative symptoms, smoking, medical illness  and depression.    Presynpatic  dopamine dysfunction is found in drug naive schizophrenic.  Due to high D2 occupancy typical antipsychotics produce more SD than atypicals. High prolactin level , and anti cholinergic effects cause  libido reduction and ED. Aripirazole is partial antagonist of D2 and  5HT1A reduces  prolactin levels  without compromising antipsychotic efficacy.PDE5 inhibitors and testosterone boosting  can  address arousal issues. Treat depression with bupropion, with  minimum sexual side effects.


Appropriate management of SD can improve QOL of psychosis patients.