Sexual Side Effects of Ziprasidone

Overview of Ziprasidone's Sexual Side Effect Profile

Ziprasidone is one of the more weight-neutral antipsychotics with fewer metabolic effects, which indirectly benefits sexual function compared to medications that cause significant weight gain and metabolic disturbances 1, 2
The American Diabetes Association recommends considering ziprasidone as a favorable option for patients concerned about sexual dysfunction due to its lower incidence of sexual side effects compared to many other antipsychotics 1, 2

Decreased libido, erectile dysfunction, and delayed ejaculation or anorgasmia may occur with ziprasidone, although they are less common than with other antipsychotics, particularly those that significantly raise prolactin levels 3
The Journal of the American Academy of Child and Adolescent Psychiatry reports that sexual side effects with ziprasidone include decreased libido, erectile dysfunction, and delayed ejaculation or anorgasmia, which are less frequent than with SSRIs or other antipsychotics 3

Ziprasidone tends to have fewer metabolic effects compared to olanzapine, quetiapine, risperidone, and clozapine, which indirectly benefits sexual function, according to the American Diabetes Association 1
Aripiprazole and ziprasidone tend to have fewer metabolic effects than other second-generation antipsychotics, making them preferable options when sexual function is a concern, as recommended by the American Diabetes Association 1
Haloperidol, clozapine, quetiapine, and risperidone tend to have more metabolic effects that can indirectly impact sexual function, according to the American Diabetes Association 1

The Journal of the American Academy of Child and Adolescent Psychiatry suggests assessing for other contributing factors, such as other medications, medical conditions, or psychological factors, if sexual side effects occur with ziprasidone 3
Considering a switch to another antipsychotic with even lower risk of sexual side effects may be necessary if sexual dysfunction is significantly impacting quality of life, as recommended by the American Academy of Child and Adolescent Psychiatry 2