Bradford J M
Division of Forensic Psychiatry, University of Ottawa, Ontario.
Can J Psychiatry. 2001 Feb;46(1):26-34. doi: 10.1177/070674370104600104.
There has been increasing interest in the treatment of sexual disorders in recent years. Sexual disorders are classified in DSM-IV as sexual dysfunctions, paraphilias, and gender identity disorders. The sexual dysfunctions are nondeviant or nonparaphillic. The sexual dysfunction disorders should include "hyperactive sexual desire disorder" under sexual desire disorders. Further, there should be a specifier for paraphilias of "with hypersexuality" or "without hypersexuality." There is still incomplete understanding of the neurobiology of sexual disorders although functional neuroanatomy and neoropharmcological research has exposed the neurotransmitters, receptors, and hormones that are involved in sexual desire. Various pharmacological agents including serotonin reuptake inhibitors, antiandrogens, LHRH agonists, and others have been documented as reducing sexual desire. An algorithm for the use of these drugs in the treatment of the paraphilias as well nonparaphilic hypersexuality is outlined. The modes of action, dosages, aims of treatment, and usual methods of prescribing these agents is reviewed in this article. Some future directions of research in pharmacological treatment is also discussed.
近年来，人们对性功能障碍的治疗越来越感兴趣。性功能障碍在《精神疾病诊断与统计手册》第四版（DSM-IV）中被归类为性功能失调、性偏好障碍和性别认同障碍。性功能失调是非异常或非性偏好的。性功能障碍应包括性欲障碍中的“性欲亢进障碍”。此外，性偏好障碍应有“伴有性欲亢进”或“不伴有性欲亢进”的说明。尽管功能性神经解剖学和神经药理学研究已经揭示了与性欲有关的神经递质、受体和激素，但对性功能障碍的神经生物学仍存在不完全的理解。包括5-羟色胺再摄取抑制剂、抗雄激素、促性腺激素释放激素激动剂等在内的各种药物已被证明可降低性欲。本文概述了这些药物用于治疗性偏好障碍以及非性偏好性性欲亢进的算法。本文回顾了这些药物的作用方式、剂量、治疗目标以及通常的处方方法。还讨论了药物治疗的一些未来研究方向。
