{"id":7492,"date":"2026-09-10T11:09:29","date_gmt":"2026-09-10T10:09:29","guid":{"rendered":"https:\/\/schizophrenia.life\/public\/?page_id=7492"},"modified":"2026-09-11T06:48:57","modified_gmt":"2026-09-11T05:48:57","slug":"candid-book-3-chapter-4","status":"publish","type":"page","link":"https:\/\/schizophrenia.life\/public\/candid-book-3-chapter-4\/","title":{"rendered":"Candid book 3 – Chapter 4"},"content":{"rendered":"\n
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Chapter 4<\/strong><\/p>\n\n\n\n

Treatment considerations in sexually active patients living with schizophrenia<\/strong><\/p>\n\n\n\n

This chapter explores how treatment may affect sexual well being, intimacy, and relationships. It emphasizes the importance of identifying possible side effects, discussing personal priorities openly, and making treatment decisions collaboratively so that care supports both clinical stability and quality of life.<\/p>\n\n\n\n

Download the chapter<\/a><\/p>\n<\/div>\n<\/div>\n\n\n<\/div><\/div><\/div><\/div>

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Mini-Glossary<\/strong><\/p>\n\n\n\n

Sexual functioning:<\/mark><\/strong> A broad concept that includes desire, arousal, satisfaction, and emotional engagement in
intimate relationships.<\/p>\n\n\n\n

Prolactin:<\/mark><\/strong> A hormone involved in reproductive and sexual functioning. Elevated levels may influence libido, menstrual cycles, and overall sexual well-being.<\/p>\n\n\n\n

Hyperprolactinemia:<\/mark><\/strong> A condition in which the level of prolactin in the blood is above the expected range, potentially affecting sexual function, fertility, and hormonal balance.<\/p>\n\n\n\n

Treatment adherence:<\/mark><\/strong> The extent to which a person follows the agreed treatment plan. It is closely linked to trust, communication, and perceived tolerability of treatment.<\/p>\n\n\n\n

Side effects:<\/mark><\/strong> Unintended effects of treatment that may influence physical, emotional, or sexual well being.<\/p>\n\n\n\n

Shared decision-making:<\/mark><\/strong> A collaborative process in which clinicians and patients make treatment decisions together, based on medical evidence and personal preferences.<\/p>\n\n\n\n

Therapeutic alliance:<\/mark><\/strong> The relationship of trust and collaboration between a patient and clinician, which supports
engagement and long-term outcomes.<\/p>\n\n\n\n

Autonomy:<\/mark><\/strong> The patient\u2019s right to make informed decisions about their own care, based on
understanding and personal values.<\/p>\n\n\n<\/div><\/div><\/div><\/div>

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Welcome to podcast #4<\/strong><\/p>\n\n\n\n

Treatment considerations in sexually active patients living with schizophrenia<\/strong><\/p>\n\n\n\n

with Elena Maurer<\/strong>, Health Journalist, and
Dr. Lukas Stein<\/strong>, Psychiatrist and Researcher<\/em><\/p>\n\n\n\n

Elena:<\/strong><\/p>\n\n\n\n

Welcome back to Living, Loving, Recovering.

In the previous chapter, we explored how body image and physical well-being shape confidence, relationships, and closeness.

Today, we take the next step, looking at something that often becomes part of that experience: treatment.

How does treatment influence intimacy, and how can these decisions be made in a way that respects both clinical needs and personal priorities?<\/mark><\/strong><\/p>\n\n\n<\/div><\/div><\/div><\/div>

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Dr. Stein:<\/strong><\/p>\n\n\n\n

Thank you, Elena. These topics can be discussed openly, and in many cases concerns can be assessed and addressed.<\/p>\n\n\n<\/div><\/div><\/div><\/div>

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Elena:<\/strong><\/p>\n\n\n\n

Many families may find it reassuring to know that these concerns can be discussed and addressed rather than simply accepted.<\/p>\n\n\n\n


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Subchapter 1.<\/strong><\/p>\n\n\n\n

Why is sexual well-being part of recovery?<\/p>\n\n\n\n<\/a>\n<\/div>\n\n\n\n

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Subchapter 2.<\/strong><\/p>\n\n\n\n

Can treatment affect intimacy and relationships?<\/p>\n\n\n\n<\/a>\n<\/div>\n\n\n\n

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Subchapter 3.<\/strong><\/p>\n\n\n\n

Why are intimacy-related side effects often not discussed?<\/p>\n\n\n\n<\/a>\n<\/div>\n<\/div>\n\n\n\n

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Subchapter 4.<\/strong><\/p>\n\n\n\n

What does shared decision-making look like in practice?<\/p>\n\n\n\n<\/a>\n<\/div>\n\n\n\n

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Subchapter 5.<\/strong><\/p>\n\n\n\n

Why does treatment choice have ethical implications?<\/p>\n\n\n\n<\/a>\n<\/div>\n\n\n\n

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Subchapter 6.<\/strong><\/p>\n\n\n\n

What can caregivers do to support communication and trust?<\/p>\n\n\n\n<\/a>\n<\/div>\n\n\n\n

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Clinical Story<\/strong><\/p>\n\n\n\n

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References<\/h5><\/div><\/div><\/div>
<\/span><\/div><\/div>
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Korchia T, Achour V, Faugere M, et al. Sexual Dysfunction in Schizophrenia: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2023;80(11):1110-1120.<\/p>

Schneider-Thoma J, Dong S, Kim DD, et al. Sexual dysfunction and other prolactin-related side effects of antipsychotic drugs in schizophrenia: Protocol for a systematic review with single-arm, pairwise, and network meta-analyses of randomized controlled trials and non randomized studies. F1000Research. 2025;13:973.<\/p>

Lin X, Spyridon Siafis, Tian J, et al. Antipsychotic-Related Prolactin Changes: A Systematic Review and Dose\u2013Response Meta-analysis. CNS Drugs. Published online 2025;39(10):937 947.<\/p>

Jiang Q, Li T, Zhao L, et al. Treatment of antipsychotic-induced hyperprolactinemia: an umbrella review of systematic reviews and meta-analyses. Frontiers in psychiatry. 2024;15:1337274.<\/p>

Lu Z, Sun Y, Zhang Y, et al. Pharmacological treatment strategies for antipsychotic induced hyperprolactinemia: a systematic review and network meta-analysis. Translational Psychiatry. 2022;12(1).<\/p>

P\u00e9rez-Revuelta JI, Gonz\u00e1lez-S\u00e1iz F, Pascual-Pa\u00f1o JM, et al. Shared decision making with schizophrenic patients: a randomized controlled clinical trial with booster sessions (DECIDE Study). Patient Education and Counseling. 2023;110:107656.<\/p>

Jackson KN, Lee AG, Ali JM, et al. Shared Decision-Making in the Management of Schizophrenia: A Systematic Review. Cureus. 2025;17(6):e87069.<\/p>

Fiorillo A, Barlati S, Bellomo A, et al. The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review. Annals of General Psychiatry. 2020;19(1).<\/p>

National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management [Internet]. London: NICE; 2014 [updated 2025 Jul 29; cited 2026 Aug 21]<\/p><\/div><\/div><\/div>\n<\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Chapter 4 Treatment considerations in sexually active patients living with schizophrenia This chapter explores how treatment may affect sexual well being, intimacy, and relationships. It emphasizes the importance of identifying possible side effects, discussing personal priorities openly, and making treatment decisions collaboratively so that care supports both clinical stability and quality of life. Download the […]<\/p>\n","protected":false},"author":12,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-sod.php","meta":{"_acf_changed":false,"rea_page_title_signed_in_meta_block_field":"","rea_page_title_signed_out_meta_block_field":"","rea_page_description_signed_in_meta_block_field":"","rea_page_description_signed_out_meta_block_field":"","rea_page_footer_id_meta_block_field":"","rea_page_footer_date_meta_block_field":"","footnotes":""},"class_list":["post-7492","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/pages\/7492","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/comments?post=7492"}],"version-history":[{"count":19,"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/pages\/7492\/revisions"}],"predecessor-version":[{"id":8100,"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/pages\/7492\/revisions\/8100"}],"wp:attachment":[{"href":"https:\/\/schizophrenia.life\/public\/wp-json\/wp\/v2\/media?parent=7492"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}