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一项关于缓释安非他酮作为选择性5-羟色胺再摄取抑制剂所致性功能障碍解毒剂的安慰剂对照试验。

A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction.

作者信息

Clayton Anita H, Warnock Julia K, Kornstein Susan G, Pinkerton Relana, Sheldon-Keller Adrienne, McGarvey Elizabeth L

机构信息

University of Virginia, Charlottesville, VA 22903, USA.

出版信息

J Clin Psychiatry. 2004 Jan;65(1):62-7. doi: 10.4088/jcp.v65n0110.

Abstract

OBJECTIVE

This study reports the results of a placebo-controlled, double-blind comparison of bupropion sustained release (SR) as an antidote for sexual dysfunction versus placebo in 42 patients with selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction. Exploratory analyses of the association of testosterone and sexual functioning in women in the study were also performed.

METHOD

Patients with DSM-IV major depression who experienced a therapeutic response to any SSRI and were experiencing medication-induced global or phase-specific sexual dysfunction, as measured by the Changes in Sexual Functioning Questionnaire (CSFQ), were randomly assigned to receive either bupropion SR 150 mg b.i.d. or placebo for 4 weeks in addition to the SSRI. Total testosterone levels were assessed at baseline and week 4.

RESULTS

The difference in global sexual functioning, based on the total CSFQ score, was not statistically significant between the 2 groups at week 4, nor were differences in orgasm, desire/ interest as measured by sexual thoughts, or self-reported arousal. There was a statistically significant difference between the 2 groups at week 4 in desire as measured by self-report feelings of desire and frequency of sexual activity. Desire/ frequency showed a significantly greater improvement among those patients receiving bupropion SR compared with placebo (Wilk's F = 5.47, df = 1, p =.024). Frequency was significantly correlated to total testosterone level at baseline (r = 0.36, p =.027) and at week 4 (r = 0.41, p =.025).

CONCLUSIONS

Bupropion SR, as an effective antidote to SSRI-induced sexual dysfunction, produced an increase in desire to engage in sexual activity and frequency of engaging in sexual activity compared with placebo. A larger study is needed to further investigate this finding.

摘要

目的

本研究报告了在42例患有选择性5-羟色胺再摄取抑制剂(SSRI)所致性功能障碍的患者中,将安非他酮缓释剂(SR)作为性功能障碍解毒剂与安慰剂进行安慰剂对照、双盲比较的结果。还对该研究中女性睾酮与性功能之间的关联进行了探索性分析。

方法

患有DSM-IV重度抑郁症且对任何一种SSRI有治疗反应、正经历药物所致全面或特定阶段性功能障碍(通过性功能问卷变化量表(CSFQ)测量)的患者,除服用SSRI外,被随机分配接受安非他酮SR 150毫克,每日两次,或安慰剂,为期4周。在基线和第4周时评估总睾酮水平。

结果

基于CSFQ总分,两组在第4周时的全面性功能差异无统计学意义,在性高潮、通过性想法测量的欲望/兴趣或自我报告的性唤起方面也无差异。两组在第4周时通过自我报告的欲望感受和性活动频率测量的欲望方面存在统计学显著差异。与安慰剂相比,接受安非他酮SR的患者在欲望/频率方面有显著更大的改善(威尔克斯F值 = 5.47,自由度 = 1,p = 0.024)。频率在基线时(r = 有统计学意义的差异。与安慰剂相比,安非他酮SR作为SSRI所致性功能障碍的有效解毒剂,使参与性活动的欲望和性活动频率增加。需要进行更大规模的研究来进一步调查这一发现。 0.36,p = 0.027)和第4周时(r = 0.41,p = 0.025)与总睾酮水平显著相关。

结论

与安慰剂相比,安非他酮SR作为SSRI所致性功能障碍的有效解毒剂,使参与性活动的欲望和性活动频率增加。需要进行更大规模的研究来进一步调查这一发现。

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