Montgomery S A, Baldwin D S, Riley A
Department of Pharmacology, Imperial College School of Medicine, P.O. Box 8751, London W13 8WH, UK.
J Affect Disord. 2002 May;69(1-3):119-40. doi: 10.1016/s0165-0327(01)00313-5.
Sexual dysfunction is recognised as a potential side effect of antidepressant therapy. However, there is little detailed information on the prevalence of drug-induced sexual dysfunction or the differences, if any, between available drugs. This article is a critical review of the literature in the area.
English-language studies on sexual dysfunction and depression or antidepressant treatments were identified by searching Medline and supplemented by manual review of their reference lists and recent journal issues available in a library. Trials of antidepressant use in anxiety disorders were identified from a Medline search and their adverse events tables scanned for data on sexual dysfunction. All trials were assessed according to predefined criteria.
Sexual dysfunction is widespread in the healthy non-depressed population and is a recognised symptom of depression and/or anxiety disorders. Sexual dysfunction has been reported with all classes of antidepressants (MAOIs, TCAs, SSRIs, SNRIs and newer antidepressants) in patients with depression and various anxiety disorders. Numerous studies have been published, but only one used a validated sexual function rating scale and most lacked either a baseline or a placebo control or both. None met all of the pre-defined assessment criteria.
The search techniques may have missed some studies and publication bias cannot be ruled out.
The existing literature confirms sexual dysfunction as a possible adverse event of all antidepressants, but it is not sufficiently robust to support claims for differences in the incidence of drug-induced sexual dysfunctions between existing antidepressant therapies. Prescribing decisions should be based on a careful assessment of the benefits and risks of therapy in the individual patient.
性功能障碍被认为是抗抑郁治疗的潜在副作用。然而，关于药物引起的性功能障碍的患病率或现有药物之间的差异（如果有的话），几乎没有详细信息。本文是该领域文献的批判性综述。
通过检索Medline确定关于性功能障碍与抑郁症或抗抑郁治疗的英文研究，并通过人工查阅其参考文献列表以及图书馆现有的近期期刊进行补充。从Medline检索中确定抗抑郁药用于焦虑症的试验，并扫描其不良事件表以获取性功能障碍的数据。所有试验均根据预定义标准进行评估。
性功能障碍在健康的非抑郁人群中普遍存在，并且是抑郁症和/或焦虑症的公认症状。在患有抑郁症和各种焦虑症的患者中，所有类型的抗抑郁药（单胺氧化酶抑制剂、三环类抗抑郁药、选择性5-羟色胺再摄取抑制剂、5-羟色胺-去甲肾上腺素再摄取抑制剂和新型抗抑郁药）均报告有性功能障碍。已经发表了大量研究，但只有一项使用了经过验证的性功能评定量表，并且大多数研究缺乏基线或安慰剂对照，或两者都缺乏。没有一项研究符合所有预定义的评估标准。
检索技术可能遗漏了一些研究，并且不能排除发表偏倚。
现有文献证实性功能障碍是所有抗抑郁药可能的不良事件，但不足以有力支持现有抗抑郁治疗之间药物引起的性功能障碍发生率存在差异的说法。处方决策应基于对个体患者治疗的益处和风险的仔细评估。
