Department of Clinical Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA.
J Sex Med. 2011 Apr;8(4):956-70. doi: 10.1111/j.1743-6109.2010.02190.x. Epub 2011 Jan 27.
The monoamine neurotransmitters serotonin, dopamine, and norepinephrine play an important role in many medical and psychological conditions, including sexual responsiveness and behavior. Pharmacological agents that modulate monoamines may help alleviate sexual dysfunction.
To provide an overview of pharmacological agents that modulate monoamines and their use in the treatment of sexual dysfunction.
EMBASE and PubMed search for articles published between 1950 and 2010 using key words "sexual dysfunction,""monoamines,""monoaminergic receptors," and "generic names for pharmacological agents."
To assess the literature evaluating the efficacy of monoamine pharmacologic agents used in the treatment of sexual dysfunction.
The literature primarily cites the use of monoaminergic agents to treat sexual side effects from serotonergic reuptake inhibitors (SSRIs), with bupropion, buspirone and ropinirole providing the most convincing evidence. Controlled trials have shown that bupropion improves overall sexual dysfunction, but not frequency of sexual activity in depressed and nondepressed patients. Nefazodone and apomorphine have been used to treat sexual dysfunction, but their use is limited by significant side effect and safety profiles. New research on pharmacologic agents with subtype selectivity at dopaminergic and serotonergic receptors and those that possess dual mechanisms of action are being investigated.
There has been tremendous progress over the past 50 years in understanding the role of monoamines in sexual function and the effect of pharmacologic agents which stimulate or antagonize monoaminergic receptors on sexual dysfunction. Nevertheless, large, double-blind, placebo-controlled studies evaluating the efficacy of currently available agents in populations without comorbid disorders are limited, preventing adequate interpretation of data. Continued research on sexual function and specific receptor subtypes will result in the development of more selective pharmacologic agents with the goal of increasing efficacy without the dose-limiting side effects of nonselective agents.
单胺神经递质血清素、多巴胺和去甲肾上腺素在许多医学和心理状况中发挥着重要作用，包括性反应和行为。调节单胺的药物可能有助于缓解性功能障碍。
概述调节单胺的药物及其在治疗性功能障碍中的应用。
使用关键词“性功能障碍”、“单胺”、“单胺能受体”和“药物通用名”，在 EMBASE 和 PubMed 上搜索 1950 年至 2010 年期间发表的文章。
评估评估用于治疗性功能障碍的单胺药理药物疗效的文献。
文献主要引用单胺能药物治疗血清素再摄取抑制剂（SSRIs）引起的性功能障碍，其中安非他酮、丁螺环酮和罗匹尼罗提供了最有说服力的证据。对照试验表明，安非他酮可改善抑郁和非抑郁患者的整体性功能障碍，但不能提高性行为频率。奈法唑酮和阿扑吗啡已被用于治疗性功能障碍，但由于严重的副作用和安全性问题，其应用受到限制。目前正在研究具有多巴胺和血清素受体亚型选择性以及具有双重作用机制的新型药物。
在过去的 50 年中，人们对单胺在性功能中的作用以及刺激或拮抗单胺能受体的药物对性功能障碍的影响有了巨大的认识。尽管如此，评估目前可用药物在无合并症人群中的疗效的大型、双盲、安慰剂对照研究有限，这使得对数据的充分解释变得困难。对性功能和特定受体亚型的持续研究将导致开发出更具选择性的药物，其目的是在不限制非选择性药物剂量限制副作用的情况下提高疗效。
