Psychiatry Department, Hospital Universitario de Salamanca, Spain.
J Sex Med. 2010 Oct;7(10):3404-13. doi: 10.1111/j.1743-6109.2010.01709.x.
Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited.
To evaluate the frequency of sexual dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions.
Subjects included were sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history.
Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex).
All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited sexual dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with sexual dysfuntion spontaneously reported it. Among the patients exhibiting sexual dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females' sexual funtioning, the severity and tolerance of sexual dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73-14.89) and conventionals, depot (OR 4.57, 95% CI 1.72-12.13) and nondepot (OR 4.92, 95% CI 1.43-16.93), showed a significant increased risk of sexual dysfunction.
Our results show that sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients.
尽管这是一种令人困扰的副作用，但目前关于抗精神病药引起的性功能障碍的信息有限。
在常规临床情况下，评估各种抗精神病药物治疗的精神障碍患者的性功能障碍频率及其对治疗依从性的影响。
纳入标准为年龄在 18 岁或以上的有精神分裂症、分裂情感障碍或其他精神障碍诊断的、有性行为的男性和女性患者。这是一项由 18 名研究者进行的多中心、横断面、自然主义研究。除了性功能外，我们还记录了人口统计学数据、根据《精神障碍诊断与统计手册（第四版）》的精神科诊断和用药史。
性相关精神障碍性功能问卷（PRSexDQ-SalSex）。
所有分析均在 243 例可评估患者中进行。大多数患者为男性（71%），最常见的诊断为精神分裂症（71%）。总体而言，根据 SalSex 评估，46%的患者存在性功能障碍（男性为 50%，女性为 37%）。只有 37%的有性功能障碍的患者会主动报告。在有性功能障碍的患者中，有 32%的人报告对这种障碍的耐受性差。除了长效针剂，它对女性性功能的影响非常重要且更大之外，无论研究何种抗精神病药，男性的性功能障碍严重程度和耐受性均较女性差。在单变量逻辑回归分析中，以奥氮平为参考类别，利培酮（比值比 [OR] 7.45，95%置信区间 [CI] 3.73-14.89）和长效针剂（OR 4.57，95% CI 1.72-12.13）和非长效针剂（OR 4.92，95% CI 1.43-16.93）的风险显著增加。
我们的研究结果表明，接受长期抗精神病药物治疗的患者性功能障碍非常常见，并且在很大一部分患者中存在严重影响。
