Possible new mechanism to explain low libido in male patients treated with tranquillizers.
Frank Pio Russo - August 24, 2016.
The most common reason for lack of compliance with tranquillizing medication, is its associated vast decrease in sexual libido. This is currently mainly attributed to its often present hyperprolactinemia and various receptor antagonisms . I am herewith elucidating a possible alternative cause, which can easily be treated with testosterone therapy: namely a drastic increase in serum SHBG - (sex hormone binding globulin) - resulting in a much lower free testosterone with obviously resultant much decreased physiological function.
I have noticed that in 2 patients - who were both firstly treated with Risperidone for some years and then further with amisulpride - the serum SHBG approximately doubled in concentration: with one patient going from a level of 29 nmol/l to a level of 63 nmol/l from before treatment to after years of therapy - that's a level that becomes 217% of the original - whilst the serum testosterone remained the same over the whole 13 years period!
Obviously this marked increase would result in a much more decreased free testosterone, with a much more reduced physiological function. It is clearly evident that this would be so! Naturally we in medicine are all about ameliorating the patients' wellbeing, and it would naturally follow that some sort of testosterone adjunctive therapy would be in order in such patients.
Finally - rather than labour the point - I'll be concise and terse and finish off by presenting my previous document on this subject thus allowing everybody to better understand the topic under consideration.
Frank Pio Russo.
Ps - the foregoing would only be invalidated if SHBH was used as the transport mechanism for both testosterone and prolactin: from memory I'm sure this is not the case as it only transports androgens - (testosterone and dihydrotestosterone) - and Oestrogens.
 Yeon Won Park & Jun Ho Lee; WORLD JOURNAL of MEN'S HEALTH; 2012 Dec; 30(3): 153–159; www.ncbi.nlm.nih.gov/pmc/articles/PMC3623530/