Philipp M, Tiller J W, Baier D, Kohnen R
Bezirkskrankenhaus Landshut, Klinik für Psychiatrie/Psychotherapie, D-84034, Landshut, Germany.
Eur Neuropsychopharmacol. 2000 Sep;10(5):305-14. doi: 10.1016/s0924-977x(00)00085-7.
To compare the emergent sexual effects of moclobemide and selective serotonin reuptake inhibitors (SSRIs) during acute and maintenance therapy in routine practice.
268 patients were evaluated for sexual function at baseline, 6 weeks, 3 and 6 months of treatment using physician ratings and self-rating questionnaires. Patients received moclobemide, an reversible monoamine oxidase A inhibitor (RIMA), or a SSRI (fluoxetine, fluvoxamine, paroxetine, sertraline).
Baseline values were similar in all groups. Incidences of impairments of sexual functioning with treatment, whether clinically relevant or not, were 24.3% with moclobemide and 61.5% with SSRIs (physician ratings), with no significant tolerance to these effects. There was a suggestion of differences between the SSRIs in their specific dysfunctions they cause. SSRIs (21.6% of patients) had about ten times the moclobemide rate (1.9%) of sexual dysfunction reported as adverse events. Antidepressant efficacy was comparable between treatments.
In patients for whom sexual function is important or sexual dysfunction is present, moclobemide should be considered a first line antidepressant.
在常规临床实践中，比较吗氯贝胺与选择性5-羟色胺再摄取抑制剂（SSRIs）在急性治疗期和维持治疗期对性功能的急性影响。
采用医生评估和自评问卷，在基线、治疗6周、3个月及6个月时对268例患者的性功能进行评估。患者接受吗氯贝胺（一种可逆性单胺氧化酶A抑制剂，RIMA）或一种SSRI（氟西汀、氟伏沙明、帕罗西汀、舍曲林）治疗。
所有组的基线值相似。治疗期间性功能障碍的发生率，无论是否具有临床相关性，吗氯贝胺组为24.3%，SSRIs组为61.5%（医生评估），对这些影响无明显耐受性。不同的SSRI在其所导致的特定功能障碍方面似乎存在差异。报告为不良事件的性功能障碍发生率，SSRIs组（21.6%的患者）约是吗氯贝胺组（1.9%）的10倍。各治疗组间抗抑郁疗效相当。
对于性功能很重要或已存在性功能障碍的患者，应考虑将吗氯贝胺作为一线抗抑郁药。
