Table 1.

Main effects of antipsychotics on sexual functioning

	Effects on sexual response
D2 agonism	Increased sexual desire (anticipation of reward)
D2 antagonism	Decreased sexual desire, sexual activity, erection, and ejaculation
5-HT2 agonism	Delay of orgasm
5-HT1a agonism	Activation of sexual behavior, facilitation of orgasm
5-HT2a and 5-HT2c antagonism	Probable stimulation of sexual behaviour
α1 antagonism	Central effect: decrease of erection, lubrication, and ejaculation Peripheral effect: may have a stimulating effect on, eg erection
α2 antagonism	Stimulation of erection
H1 antagonism	Indirect effect on sexual performance through sedation
M1 antagonism	Decreased erection and lubrication

Note: D, dopamine receptor; 5HT, serotonin receptor; α, alpha-adrenergic receptor (or alpha-adrenoceptor); H, histamine receptor; M, muscarinic receptor (a subtype of acetylcholine receptor).