Zajecka J
Woman's Board Depression Treatment Research Center, Rush-Presbyterian St. Luke's Medical Center, Chicago, Ill, USA.
J Clin Psychiatry. 2001;62 Suppl 3:35-43.
Sexual dysfunction and dissatisfaction are common symptoms associated with depression. Optimal antidepressant treatment should result in remission of the symptoms of the underlying illness and minimize the potential for short- and long-term adverse effects, including sexual dysfunction. Sexual dysfunction and dissatisfaction are frequently persistent or worsen with the use of some antidepressant medications; this sexual dysfunction and dissatisfaction can have negative impact on adherence to treatment, quality of life, and the possibility of relapse. Successful management of sexual complaints during antidepressant treatment should begin with a systematic approach to determine the type of sexual dysfunction, potential contributing factors, and finally management strategies that should be tailored to the individual patient. The basic physiologic mechanisms of the normal sexual phases of libido, arousal, and orgasm and how these mechanisms may be interrupted by some antidepressants provide a framework for the clinician to utilize in order to minimize sexual complaints when initiating and continuing antidepressant treatment. This article provides guidelines, based upon this type of model, for the assessment, management, and prevention of sexual side effects associated with antidepressant treatment.
性功能障碍和性不满是与抑郁症相关的常见症状。最佳的抗抑郁治疗应能使潜在疾病的症状得到缓解，并将包括性功能障碍在内的短期和长期不良反应的可能性降至最低。性功能障碍和性不满在使用某些抗抑郁药物时常常持续存在或加重；这种性功能障碍和性不满会对治疗依从性、生活质量以及复发可能性产生负面影响。在抗抑郁治疗期间成功处理性方面的问题，应从一种系统的方法开始，以确定性功能障碍的类型、潜在的促成因素，最后是应针对个体患者量身定制的管理策略。性欲、性唤起和性高潮等正常性阶段的基本生理机制，以及这些机制如何可能被某些抗抑郁药物打断，为临床医生在开始和持续抗抑郁治疗时提供了一个框架，以便尽量减少性方面的问题。本文基于这种模型提供了评估、管理和预防与抗抑郁治疗相关的性副作用的指南。
