Baggaley Martin
South London & Maudsley NHS Foundation Trust Clinical Director, Sex & Relationship Problems Clinic, York Clinic, Guy's Hospital, London, UK.
Hum Psychopharmacol. 2008 Apr;23(3):201-9. doi: 10.1002/hup.924.
Antipsychotic medications are known to be commonly associated with sexual dysfunction. Sexual dysfunction is estimated to affect 30-80% of patients with schizophrenia and is a major cause of poor quality of life. However, few comparative studies on the sexual dysfunction effects associated with antipsychotic medication have been published and the effects of the newer atypical antipsychotics have been largely unexamined.
This review aims to examine the latest evidence regarding the sexual function effects of different antipsychotic medications, particularly the newer prolactin-sparing drugs, quetiapine and aripiprazole, in patients with schizophrenia and schizoaffective psychosis.
A literature search was conducted within PubMed/MEDLINE using the terms risperidone, haloperidol, clozapine, olanzapine, ziprasidone, quetiapine, aripiprazole; sexual dysfunction; schizophrenia. The results were limited to studies published since 2002.
Recently published studies show that the relative impact of antipsychotics on sexual dysfunction can be summarised as risperidone > typical antipsychotics (haloperidol) > olanzapine > quetiapine > aripiprazole.
The availability of prolactin-sparing antipsychotics should enable psychiatrists to consider and manage proactively the sexual function consequences of pharmacological intervention, thereby improving sexual side effects, which may lead to improved treatment adherence and psychiatric outcome in patients with schizophrenia.
已知抗精神病药物常与性功能障碍相关。据估计,性功能障碍影响30%-80%的精神分裂症患者,是生活质量低下的主要原因。然而,关于抗精神病药物相关性性功能障碍影响的比较研究很少发表,新型非典型抗精神病药物的影响在很大程度上未得到研究。
本综述旨在研究不同抗精神病药物对性功能影响的最新证据,特别是新型泌乳素释放抑制药物喹硫平和阿立哌唑对精神分裂症和分裂情感性精神病患者的影响。
在PubMed/MEDLINE中使用利培酮、氟哌啶醇、氯氮平、奥氮平、齐拉西酮、喹硫平、阿立哌唑;性功能障碍;精神分裂症等检索词进行文献检索。结果限于2002年以来发表的研究。
最近发表的研究表明,抗精神病药物对性功能障碍的相对影响可总结为利培酮>典型抗精神病药物(氟哌啶醇)>奥氮平>喹硫平>阿立哌唑。
泌乳素释放抑制抗精神病药物的应用应使精神科医生能够主动考虑和处理药物干预对性功能的影响,从而改善性副作用,这可能会提高精神分裂症患者的治疗依从性和精神状态。