Saiz-Ruiz Jerónimo, Montes Jose Manuel, Ibáñez Angela, Díaz Marina, Vicente Francisco, Pelegrín Carmelo, Viñas Rosa, Arias Francisco, Carrasco Jose Luis, Ferrando Laura
Ramón y Cajal Research Group, Alcala University, Madrid, Spain.
Hum Psychopharmacol. 2005 Aug;20(6):435-40. doi: 10.1002/hup.706.
Antidepressant-induced sexual dysfunction is a frequent side effect which may greatly contribute to treatment non compliance. Mirtazapine has a pharmacological profile expected to result in a lack of sexual dysfunction. The main purpose of this 6-month open-label study was to evaluate the effects of mirtazapine on sexual function of a sample of depressed patients.
Seventy-eight patients meeting DSM-IV criteria for major depression or adjustment disorder with depressed mood or with mixed anxiety and depressed mood, sexually active prior to the episode, were treated with mirtazapine (15-60 mg/day). Effectiveness was assessed using the 17-item Hamilton rating scale for depression (HAM-D-17), the Hamilton rating scale for anxiety (HAM-A) and the clinical global impression (severity and improvement) scales (CGI). Sexual function was evaluated with the psychotropic-related sexual dysfunction questionnaire (PRSexDQ) which detects clinical changes in sexual dysfunction.
Forty-eight patients (61.5%) were experiencing sexual dysfunction at baseline. A return to normal sexual functioning was observed in 27 of 38 (71.1%) patients completing the study. Significant reductions in mean total PRSexDQ scores were detected at day 90 and endpoint and only four patients withdrew or required dose reduction due to mirtazapine-induced sexual dysfunction. A total of 37 patients (47.4%) achieved complete remission of depression (HAM-D-17 score <or= 7) at endpoint. Only seven patients (9.0%) withdrew the study because of adverse events.
Mirtazapine showed in this study that it is an effective and well-tolerated antidepressant treatment with a possibly lower incidence of sexual side effects than other antidepressants.
抗抑郁药引起的性功能障碍是一种常见的副作用，可能极大地导致治疗依从性差。米氮平具有预期不会导致性功能障碍的药理学特性。这项为期6个月的开放标签研究的主要目的是评估米氮平对一组抑郁症患者性功能的影响。
78例符合DSM-IV标准的重度抑郁症或伴有抑郁情绪或混合性焦虑和抑郁情绪的适应障碍患者，在发病前有性活动，接受米氮平（15 - 60毫克/天）治疗。使用17项汉密尔顿抑郁评定量表（HAM-D-17）、汉密尔顿焦虑评定量表（HAM-A）和临床总体印象（严重程度和改善情况）量表（CGI）评估疗效。使用检测性功能障碍临床变化的精神药物相关性性功能障碍问卷（PRSexDQ）评估性功能。
48例患者（61.5%）在基线时存在性功能障碍。在完成研究的38例患者中的27例（71.1%）观察到性功能恢复正常。在第90天和终点时检测到PRSexDQ平均总分显著降低，只有4例患者因米氮平引起的性功能障碍而退出或需要减量。共有37例患者（47.4%）在终点时实现了抑郁症的完全缓解（HAM-D-17评分≤7）。只有7例患者（9.0%）因不良事件退出研究。
本研究表明，米氮平是一种有效且耐受性良好的抗抑郁治疗药物，其性副作用发生率可能低于其他抗抑郁药。
