Seo K K, Kim S C, Lee M Y
Department of Urology and Physiology, College of Medicine, Chung-Ang University, Seoul, Korea.
J Urol. 2001 Jun;165(6 Pt 1):2110-4. doi: 10.1097/00005392-200106000-00079.
We compared the peripheral inhibitory effects of the tricyclic antidepressant clomipramine with those of various selective serotonin re-uptake inhibitors on the contractile response of the vas deferens.
The contractile responses of 17 circular smooth muscle strips of human vas deferens to 10-4 M. norepinephrine were observed in the absence and presence of clomipramine, and the selective serotonin re-uptake inhibitors fluoxetine, sertraline and paroxetine. The intraluminal pressure response of rat vas deferens to electrical stimulation of the hypogastric nerve was measured in 5 rats in the central plus peripheral effect group before and after the intravenous injection of 4.2 mg./kg. clomipramine or 8.3 mg./kg. sertraline. The pressure response to each agent was also observed after the transection of all proximal sympathetic input to the hypogastric nerve in 5 animals in the peripheral effect group.
Clomipramine was about 100-fold more potent than sertraline, fluoxetine or paroxetine for inhibiting the norepinephrine induced contraction of human vasal muscle strips. The inhibitory effect of sertraline on rat intravasal pressure in the peripheral effect group was significantly lower than in the central plus peripheral effect group (p <0.05), while no significant difference was noted in the 2 groups regarding clomipramine. The effect of clomipramine was significantly higher than that of sertraline in the central plus peripheral and peripheral effect groups (p <0.01).
Differences in potency of the peripheral inhibitory effects of the selective serotonin re-uptake inhibitors and clomipramine may contribute to their differential effects on delaying ejaculatory latency in patients with premature ejaculation.
我们比较了三环类抗抑郁药氯米帕明与各种选择性5-羟色胺再摄取抑制剂对外周输精管收缩反应的抑制作用。
观察了17条人输精管环形平滑肌条在无和有氯米帕明以及选择性5-羟色胺再摄取抑制剂氟西汀、舍曲林和帕罗西汀存在的情况下对10⁻⁴M去甲肾上腺素的收缩反应。在5只大鼠组成的中枢加外周效应组中,静脉注射4.2mg/kg氯米帕明或8.3mg/kg舍曲林前后,测量大鼠输精管对腹下神经电刺激的腔内压力反应。在5只动物组成的外周效应组中,切断所有进入腹下神经的近端交感神经输入后,也观察了每种药物的压力反应。
氯米帕明抑制去甲肾上腺素诱导的人输精管肌条收缩的效力比舍曲林、氟西汀或帕罗西汀强约100倍。在外周效应组中,舍曲林对大鼠输精管内压力的抑制作用明显低于中枢加外周效应组(p<0.05),而两组中氯米帕明的作用无明显差异。在中枢加外周效应组和外周效应组中,氯米帕明的作用明显高于舍曲林(p<0.01)。
选择性5-羟色胺再摄取抑制剂和氯米帕明外周抑制作用效力的差异可能导致它们对早泄患者射精潜伏期延迟的不同作用。