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Many sexual symptoms resolve as the mental state improves, but treatment\u2010related sexual adverse events tend to persist over time, and are unfortunately under\u2010recognized by clinicians and scarcely investigated in clinical trials. Treatment\u2010emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.<\/jats:p>","DOI":"10.1002\/wps.20509","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T20:40:17Z","timestamp":1516394417000},"page":"3-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":175,"title":["The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management"],"prefix":"10.1002","volume":"17","author":[{"given":"Angel L.","family":"Montejo","sequence":"first","affiliation":[{"name":"Department of Nursing and Institute of Biomedicine of Salamanca Neurosciences Area, University Hospital of Salamanca Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Montejo","sequence":"additional","affiliation":[{"name":"Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Sciences, Faculty of Medicine University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6163.2012.00334.x"},{"key":"e_1_2_6_3_1","article-title":"The role of atypical antipsychotics in sexuality: road to recovery in schizophrenia","author":"Adam RL","journal-title":"Curr Drug Targets"},{"key":"e_1_2_6_4_1","article-title":"Psychosis as a barrier to the expression of sexuality and intimacy: an environmental risk?","author":"Jager J","journal-title":"Schizophr Bull"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2016.08.022"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2015.11.002"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2489"},{"issue":"1","key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0924-9338(14)78746-2","article-title":"Sexual and relational dysfunctions in people with schizophrenia","volume":"29","author":"Montejo AL","year":"2014","journal-title":"Eur Psychiatry"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01795.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/2046-4053-3-116","article-title":"The risk of elevated prolactin levels in pediatric patients exposed to antipsychotics for the treatment of schizophrenia and schizophrenia spectrum disorders: protocol for a systematic review and meta\u2010analysis","volume":"3","author":"Druyts E","year":"2014","journal-title":"Syst Rev"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/713847170"},{"key":"e_1_2_6_12_1","first-page":"31","article-title":"Antipsychotics and sexual dysfunction: epidemiology, mechanisms and management","volume":"10","author":"Chiesa A","year":"2013","journal-title":"Clin Neuropsychiatry"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2007.01.001"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01709.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.4103\/0019-5545.171856","article-title":"Comparative study of sexual dysfunction and serum prolactin level associated with olanzapine, risperidone, and clozapine in patients with remitted schizophrenia","volume":"57","author":"Sathish Kumar SV","year":"2015","journal-title":"Indian J Psychiatry"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3182199bcc"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00131746-200101000-00005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0309"},{"key":"e_1_2_6_19_1","first-page":"674","article-title":"The facts about sexual (dys)function in schizophrenia: an overview of clinically relevant findings. 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