DeBattista Charles, Solvason Brent, Poirier Jennifer, Kendrick Ellen, Loraas Emily
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif 94305, USA.
J Clin Psychiatry. 2005 Jul;66(7):844-8. doi: 10.4088/jcp.v66n0706.
Sexual side effects are among the common reasons patients discontinue selective serotonin reuptake inhibitors (SSRIs). While many antidotes have been proposed, few have been subjected to double-blind trials. Some evidence has suggested that bupropion may be an effective antidote for SSRI-induced sexual dysfunction. In this double-blind trial, the efficacy of a standard dose of bupropion sustained release (SR) is evaluated in the treatment of SSRI-induced sexual dysfunction.
Patients with a history of SSRI-induced sexual side effects were randomly assigned to adjunctive treatment with either bupropion SR 150 mg daily or placebo for 6 weeks. Assessments of sexual function and interest included the Arizona Sexual Experiences Scale (ASEX), Brief Index of Sexual Functioning, and a 10-point visual analogue scale. Efficacy was defined as a 50% improvement on the ASEX at the end of 6 weeks. Data were collected from January 1999 to March 2001.
Forty-one patients entered the study and completed the 6-week trial. No significant differences were seen between placebo and bupropion SR on the ASEX or on any measure of sexual functioning at the end of the trial.
A fixed dose of 150 mg/day of bupropion SR taken in the morning does not appear to be effective in the treatment of SSRI-induced sexual dysfunction. Additional trials will be required to define what role, if any, bupropion might have in the treatment of SSRI-induced sexual side effects.
性功能副作用是患者停用选择性5-羟色胺再摄取抑制剂（SSRI）的常见原因之一。虽然已经提出了许多解药，但很少有进行双盲试验的。一些证据表明安非他酮可能是治疗SSRI引起的性功能障碍的有效解药。在这项双盲试验中，评估了标准剂量的安非他酮缓释剂（SR）治疗SSRI引起的性功能障碍的疗效。
有SSRI引起的性功能副作用病史的患者被随机分配接受每日150毫克安非他酮SR辅助治疗或安慰剂治疗6周。性功能和性兴趣评估包括亚利桑那性体验量表（ASEX）、性功能简要指数和10分视觉模拟量表。疗效定义为6周结束时ASEX改善50%。数据收集于1999年1月至2001年3月。
41名患者进入研究并完成了6周试验。试验结束时，安慰剂组和安非他酮SR组在ASEX或任何性功能指标上均无显著差异。
每天早上服用固定剂量150毫克的安非他酮SR似乎对治疗SSRI引起的性功能障碍无效。需要进一步试验来确定安非他酮在治疗SSRI引起的性功能副作用中可能起到的作用（如果有的话）。
