Wirshing Donna A, Pierre Joseph M, Marder Stephen R, Saunders C Scott, Wirshing William C
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine and VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
Schizophr Res. 2002 Jul 1;56(1-2):25-30. doi: 10.1016/s0920-9964(01)00271-7.
The novel antipsychotic medications offer a more favorable extrapyramidal side effect profile than conventional agents. It is uncertain that the novel antipsychotics have a benefit in terms of sexual side effects.
We prospectively administered a survey of sexual functioning to 25 male patients with DSM-IV schizophrenia, taking conventional and novel antipsychotics. Contrasts were made between three treatment groups: clozapine (CLOZ), risperidone (RIS), and a combined haloperidol/fluphenazine (HAL/FLU) group.
A decrease in overall sexual functioning was reported in all medication groups (40-71%). The majority of subjects taking RIS or HAL/FLU reported a decline in one or more aspects of sexual functioning. Examining specific aspects of sexual functioning revealed that, a decline in sexual interest was significantly less common on CLOZ compared to RIS (0 vs. 64%; chi(2)=6.1, df=1, p=0.01) or HAL/FLU (0 vs. 67%; chi(2)=5.2, df=1, p=0.02), while a decline in the erectile frequency was significantly more common on RIS compared to CLOZ (40 vs. 93%; chi(2)=6.2, df=1, p=0.01) or HAL/FLU (50 vs. 93%; chi(2)=4.8, df=1, p=0.03) (0%). For enjoyment of orgasm and ejaculatory volume, significantly fewer CLOZ compared to RIS subjects reported a decline (20 vs. 86%; chi(2)=7.4, df=1, p=0.01).
Sexual side effects are common clinically pertinent adverse effects associated with both novel and conventional antipsychotic medications. They deserve increased attention in clinical work and future research with emerging antipsychotic drugs.
新型抗精神病药物比传统药物具有更有利的锥体外系副作用谱。新型抗精神病药物在性功能副作用方面是否有益尚不确定。
我们对25名患有DSM-IV精神分裂症、正在服用传统和新型抗精神病药物的男性患者进行了一项性功能前瞻性调查。对三个治疗组进行了对比：氯氮平（CLOZ）组、利培酮（RIS）组和氟哌啶醇/氟奋乃静联合（HAL/FLU）组。
所有药物组均报告性功能整体下降（40%-71%）。大多数服用RIS或HAL/FLU的受试者报告性功能的一个或多个方面有所下降。检查性功能的具体方面发现，与RIS组（0%对64%；χ²=6.1，自由度=1，p=0.01）或HAL/FLU组（0%对67%；χ²=5.2，自由度=1，p=0.02）相比，CLOZ组性兴趣下降的情况明显较少，而与CLOZ组（40%对93%；χ²=6.2，自由度=1，p=0.01）或HAL/FLU组（50%对93%；χ²=4.8，自由度=1，p=0.03）相比，RIS组勃起频率下降的情况明显更常见。对于性高潮的愉悦感和射精量，与RIS组受试者相比，报告下降的CLOZ组受试者明显更少（20%对86%；χ²=7.4，自由度=1，p=0.01）。
性功能副作用是新型和传统抗精神病药物常见的临床相关不良反应。在临床工作和新型抗精神病药物的未来研究中，它们值得更多关注。
