Sexual function despite hyperprolactinemia: a 24-month analysis of paliperidone palmitate versus haloperidol decanoate.
World J Biol PsychiatryJul 13, 2026 (epub)
Clinical ResearchPsychiatry
Alessandro Serretti
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In 30 seconds
This randomized controlled trial compared the effects of paliperidone palmitate (PP) and haloperidol decanoate (HD) on sexual function over 24 months in individuals with schizophrenia. Despite PP causing higher prolactin levels, the ASEX trajectories for sexual function were similar between the two treatments. However, a significant late advantage for PP was noted (p = 0.019).
Key findings
- 49% prevalence of baseline sexual dysfunction was observed in both treatment groups.
- PP resulted in higher prolactin levels throughout the follow-up period (all p < 0.001).
- ASEX trajectories did not significantly differ between PP and HD over 24 months.
- Greater prolactin increase was associated with worsening ASEX scores at month 12 (r = 0.21, p = 0.013).
Why it matters
Understanding the long-term effects of antipsychotic medications on sexual function is crucial for improving patient quality of life and adherence to treatment. This study highlights the need for careful monitoring of sexual health in patients receiving these medications.