Clayton A H, McGarvey E L, Abouesh A I, Pinkerton R C
Department of Psychiatric Medicine, University of Virginia, Charlottesville 22903, USA.
J Clin Psychiatry. 2001 Mar;62(3):185-90. doi: 10.4088/jcp.v62n0309.
We examine changes in sexual functioning and depressive symptoms in patients' transition from a selective serotonin reuptake inhibitor (SSRI), which induced both a therapeutic response and sexual dysfunction, to bupropion sustained release (SR) over the course of an 8-week trial.
The study included 11 adults (8 women and 3 men) who had a DSM-IV diagnosis of major depressive disorder in remission (Hamilton Rating Scale for Depression [HAM-D] score < 11) and were receiving an SSRI. Depression (using the HAM-D) and sexual dysfunction (using the Changes in Sexual Functioning Questionnaire) were assessed at baseline, 2 weeks after bupropion SR was added to the current antidepressant (combined treatment), 2 weeks after taper of the SSRI was initiated and completed, and after 4 weeks of bupropion SR monotherapy. T tests were performed to assess changes in depression and sexual function.
Patient participation dropped from the initial group of 11 at week 2 to 9 at week 4 and to 6 by week 8. Sexual functioning improved from week 0 (baseline) to week 2 and from week 2 to week 4. The patients showed no significant change in mean HAM-D scores in weekly comparisons during the study period; 55% of patients completed the substitution without significant adverse events or recurrence of depressive symptoms.
Bupropion SR as a treatment for depression also alleviates sexual dysfunction due to SSRI treatment. Results show that sexual functioning improves after the addition of bupropion SR to SSRI treatment and continues to improve, after discontinuation of the SSRI, with bupropion SR treatment alone.
我们研究了患者在为期8周的试验过程中，从诱导治疗反应和性功能障碍的选择性5-羟色胺再摄取抑制剂（SSRI）转换为安非他酮缓释剂（SR）时性功能和抑郁症状的变化。
该研究纳入了11名成年人（8名女性和3名男性），他们符合《精神疾病诊断与统计手册》第四版（DSM-IV）中缓解期重度抑郁症的诊断标准（汉密尔顿抑郁量表[HAM-D]评分<11），且正在接受SSRI治疗。在基线时、在当前抗抑郁药中添加安非他酮SR后2周（联合治疗）、开始并完成SSRI减药后2周以及安非他酮SR单药治疗4周后，评估抑郁（使用HAM-D）和性功能障碍（使用性功能变化问卷）。进行t检验以评估抑郁和性功能的变化。
患者参与率从第2周的初始11人组降至第4周的9人，到第8周降至6人。性功能从第0周（基线）到第2周以及从第2周到第4周有所改善。在研究期间的每周比较中，患者的平均HAM-D评分无显著变化；55%的患者完成了换药，且无明显不良事件或抑郁症状复发。
安非他酮SR作为抑郁症的一种治疗方法，也可缓解因SSRI治疗导致的性功能障碍。结果表明，在SSRI治疗中添加安非他酮SR后性功能得到改善，在停用SSRI后，仅使用安非他酮SR治疗时性功能仍持续改善。
