Smith S M, O'Keane V, Murray R
Department of Psychological Medicine, Institute of Psychiatry, London, UK.
Br J Psychiatry. 2002 Jul;181:49-55. doi: 10.1192/bjp.181.1.49.
Antipsychotic drugs are associated with sexual dysfunction but the mechanisms are poorly understood.
To ascertain the frequency of sexual dysfunction in patients taking conventional antipsychotics and to determine the possible underlying mechanisms.
Sexual dysfunction was assessed in 101 patients receiving conventional antipsychotic medication, 57 normal controls and 55 controls attending a sexual dysfunction clinic.
Sexual dysfunction occurred in 45% of patients taking antipsychotic medication, 17% of normal controls and 61% of controls attending a sexual dysfunction clinic. Sexual dysfunction was associated with autonomic side-effects in normoprolactinaemic males, but the presence of hyperprolactinaemia overrode other causes of sexual dysfunction. For women, hyperprolactinaemia was the main cause of sexual dysfunction.
Conventional anti-psychotic medications cause significant levels of sexual dysfunction. Clinicians should routinely enquire about sexual symptoms prior to the prescription of antipsychotics and on follow-up.
抗精神病药物与性功能障碍有关，但相关机制尚不清楚。
确定服用传统抗精神病药物患者性功能障碍的发生率，并确定可能的潜在机制。
对101名接受传统抗精神病药物治疗的患者、57名正常对照者和55名性功能障碍门诊对照者进行性功能障碍评估。
服用抗精神病药物的患者中45%出现性功能障碍，正常对照者中17%出现，性功能障碍门诊对照者中61%出现。在泌乳素正常的男性中，性功能障碍与自主神经副作用有关，但高泌乳素血症的存在掩盖了性功能障碍的其他原因。对于女性，高泌乳素血症是性功能障碍的主要原因。
传统抗精神病药物会导致显著程度的性功能障碍。临床医生在开具抗精神病药物处方前及随访时应常规询问性症状。
