Worthington J J, Simon N M, Korbly N B, Perlis R H, Pollack M H
Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
Int Clin Psychopharmacol. 2002 Nov;17(6):307-10. doi: 10.1097/00004850-200211000-00006.
Sexual dysfunction is a relatively common side-effect of antidepressants, occurring in approximately one-half of patients, and is associated with significant distress and treatment non-compliance. Dopaminergic agents have been reported to be helpful for the treatment of antidepressant-induced sexual dysfunction and, in this report, we examined the efficacy of the dopamine agonist ropinirole for this indication. Thirteen patients (three women, 10 men), aged 42.6 +/- 7.7 years, who reported sexual dysfunction on a stable dose of antidepressant, were treated openly with ropinirole initiated at 0.25 mg/day and titrated up to 2-4 mg/day over 4 weeks, as tolerated. Ten of the 13 took ropinirole for at least 4 weeks, one discontinued due to an adverse event and two because of lack of response. Sexual dysfunction, as assessed by the Arizona Sexual Experience Scale scores, was reduced from 18.8 +/- 3.6 to 13.8 +/- 4.3 after 4 weeks on ropinirole at a mean dose of 2.1 mg/day. Overall, seven of 13 patients (54%) were rated as responders on the Clinical Global Impression of Improvement Scale. The addition of ropinirole may represent a potentially useful treatment strategy for antidepressant-induced sexual dysfunction.
性功能障碍是抗抑郁药较为常见的副作用,约半数患者会出现,且与显著的痛苦及治疗依从性差相关。据报道,多巴胺能药物有助于治疗抗抑郁药引起的性功能障碍,在本报告中,我们研究了多巴胺激动剂罗匹尼罗用于该适应症的疗效。13例患者(3名女性,10名男性),年龄42.6±7.7岁,在稳定剂量的抗抑郁药治疗期间出现性功能障碍,接受罗匹尼罗开放治疗,起始剂量为0.25mg/天,根据耐受情况在4周内滴定至2 - 4mg/天。13例中有10例服用罗匹尼罗至少4周,1例因不良事件停药,2例因无反应停药。根据亚利桑那性体验量表评分评估,在平均剂量为2.1mg/天的罗匹尼罗治疗4周后,性功能障碍评分从18.8±3.6降至13.8±4.3。总体而言,13例患者中有7例(54%)在临床总体改善印象量表上被评为有反应者。添加罗匹尼罗可能是治疗抗抑郁药引起的性功能障碍的一种潜在有用的治疗策略。