Balon Richard, Segraves R Taylor
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA.
J Sex Marital Ther. 2008;34(4):353-65. doi: 10.1080/00926230802096390.
There are many management strategies and antidotes available for sexual dysfunction associated with antidepressants available. However, only a few of these strategies and antidotes were tested in rigorous trials and most of them probably will not be rigorously tested. Surveying the prescribing practices of experts in this area provides another opportunity to evaluate these strategies and antidotes. The authors surveyed 29 (of 50) "expert" psychiatrists in the area of sexual dysfunction associated with antidepressants. Switching to another antidepressant, decreasing the dose of an antidepressant, and adding oral agents such as bupropion, phosphodiesterase-5 inhibitors, and some dopaminergic agents (dextroamphetamine, methylphenidate) and a testosterone patch in some dysfunctions (libido, orgasm) are management strategies most frequently used by the experts. The experts also consider these strategies as the most effective ones. These findings are compared with other studies and discussed with regard to the evidence from clinical trials.
对于与抗抑郁药相关的性功能障碍,有许多管理策略和解毒剂可供使用。然而,这些策略和解毒剂中只有少数在严格的试验中得到了测试,而且其中大多数可能不会经过严格测试。调查该领域专家的处方习惯为评估这些策略和解毒剂提供了另一个机会。作者对50名与抗抑郁药相关性功能障碍领域的“专家”精神科医生中的29名进行了调查。换用另一种抗抑郁药、降低抗抑郁药剂量、添加口服药物如安非他酮、磷酸二酯酶-5抑制剂以及一些多巴胺能药物(右旋苯丙胺、哌醋甲酯),以及在某些性功能障碍(性欲、性高潮)中添加睾酮贴片,是专家们最常使用的管理策略。专家们也认为这些策略是最有效的。将这些发现与其他研究进行了比较,并根据临床试验的证据进行了讨论。