SEXUAL DYSFUNCTION MECHANISM IN METHADONE MAINTENANCE PATIENTS

Background and Aim : Opioid substitution treatment is the most common and most effective modality for the treatment of opioid dependence. Sexual dysfunction is a commonly reported side effect of opioid medications specially methadone Methods : This study is a review of the literature on mechanisms of sexual dysfunction in methadone treated patients. The search for articles was performed on the PubMed, Medline, and Google Scholar online databases, using the search terms Sexual dysfunction, , Opioid , Addiction , Methadone Results : Methadone is largely recognized as an effective treatment for opiate-dependent patients. Chronic opioid use suppresses the hypothalamic pituitary gonadal axis resulting in secondary testosterone deficiency known as Opioid-Induced Androgen Deficiency. Persistently, low testosterone levels are associated with adverse musculoskeletal, metabolic, and neuropsychiatric consequences. Also, it causes reduced brain dopaminergic action resulting in significant sexual dysfunction. Increased blood prolactin levels and the effect of its negative feedback on LH release leading to decreased testosterone production too. The meta-analytical pooled prevalence for sexual dysfunction among methadone users was 52% (95% confidence interval (CI) [0.39, 0.65]), whereby the hypoactive sexual desire and low libido were the most prevalent sexual dysfunctions. Conclusion : The authors concluded that long acting preparations (methadone) lead to sustained suppression of the HPG and therefore result in lower testosterone levels

Keywords:

Sexual dysfunction , , Opioid , Addiction , Methadone