Sexual Side Effects of Quetiapine (Seroquel)
Yes, Seroquel (quetiapine) can cause sexual side effects, although they occur less frequently than with many other psychotropic medications.
Documented Sexual Side Effects of Quetiapine
According to the FDA drug label for quetiapine, sexual side effects are documented but relatively uncommon compared to other psychiatric medications 1:
- Priapism is specifically listed as a reported adverse reaction, though rare
- Galactorrhea (abnormal milk production) is mentioned as a potential side effect
- Hormone level alterations were reported in 3% of patients in adjunct therapy trials
Unlike selective serotonin reuptake inhibitors (SSRIs) which commonly cause sexual dysfunction in 40-70% of patients 2, quetiapine's sexual side effect profile appears to be less prominent in clinical documentation.
Mechanism of Sexual Side Effects
The sexual side effects of quetiapine may be related to:
- Dopamine antagonism: Quetiapine blocks dopamine D2 receptors, which can potentially affect sexual function 3
- Prolactin effects: Though less pronounced than with typical antipsychotics, quetiapine can sometimes increase prolactin levels, which may impact sexual function 3
- Sedative properties: The sedating effects of quetiapine may indirectly reduce sexual interest or function
Comparison to Other Psychiatric Medications
When considering sexual side effects of psychiatric medications:
- Antipsychotics that strongly block dopamine receptors and increase prolactin levels are more likely to cause sexual dysfunction 3
- SSRIs frequently (>60%) cause decreased libido and delayed orgasm, and sometimes (30%) cause anorgasmia and arousal difficulties 3
- Quetiapine appears to have a more favorable sexual side effect profile than many other antipsychotics and antidepressants 4
Clinical Implications and Management
For patients experiencing sexual side effects with quetiapine:
- Assess baseline sexual function before starting treatment to better evaluate medication effects 5
- Regularly inquire about sexual side effects as patients may not spontaneously report them 5
- Consider dose adjustment if sexual side effects emerge
- Consider medication alternatives with lower sexual side effect profiles if appropriate for the patient's condition
- PDE-5 inhibitors may be helpful for managing erectile dysfunction if it occurs 5
Important Considerations
- Sexual dysfunction can significantly impact quality of life and medication adherence 2
- Young patients with psychosis and concomitant sexual dysfunction tend to show poor compliance in chronic treatments 3
- The implications of psychotropic-related sexual dysfunction are particularly relevant for patients under long-term treatment who previously had satisfactory sexual lives 3
While quetiapine can cause sexual side effects, they appear to be less common than with many other psychiatric medications, particularly SSRIs. However, clinicians should still monitor for these effects and address them promptly if they occur to ensure treatment adherence and quality of life.