Depression Clinical and Research Program, Massachusetts General Hospital, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th floor, Boston, MA 02114, USA.
Eur Psychiatry. 2012 Aug;27(6):451-4. doi: 10.1016/j.eurpsy.2011.01.003. Epub 2011 Mar 12.
Sexual dysfunction is a known side effect of antidepressant treatment (ADT), affecting up to 58-73% of those who receive ADT, potentially affecting antidepressant adherence. Consequently, it is vital to develop novel treatments that target antidepressant-induced sexual dysfunction.
We examined whether adjunctive S-adenosyl-l-methionine (SAMe) is associated with greater improvement in sexual functioning than adjunctive placebo by measuring changes in sexual functioning using the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) during a 6-week, single-center, randomized, double-blind trial of SAMe augmentation for SSRI/SNRI- nonresponders.
Controlling for the degree of arousal dysfunction at baseline as well as the degree of change in HDRS-17 scale scores during the course of the study, men treated with adjunctive SAMe demonstrated significantly lower arousal dysfunction at endpoint than those treated with adjunctive placebo. In addition, controlling for the degree of erectile dysfunction at baseline as well as the degree of change in HDRS-17 scale scores, men treated with adjunctive SAMe demonstrated significantly lower erectile dysfunction at endpoint than those treated with adjunctive placebo.
In the present study, we have observed that adjunctive SAMe can have positive benefit on male arousal and erectile dysfunction, independent of improvement in depressive symptoms. These findings are preliminary, and warrant replication. CLINICAL TRIALS.GOV IDENTIFIER: NCT00093847; titled 'Optimizing the Effectiveness of Selective Serotonin Reuptake Inhibitors (SSRIs) in Treatment-Resistant Depression', accessible at: http://clinicaltrials.gov/ct2/show/NCT00093847.
性障碍是抗抑郁治疗(ADT)已知的副作用,影响多达 58-73%接受 ADT 的患者,可能影响抗抑郁药的依从性。因此,开发针对抗抑郁药引起的性障碍的新疗法至关重要。
我们通过使用马萨诸塞州总医院性功能问卷(MGH-SFQ)测量性功能的变化,来评估在 6 周的单中心、随机、双盲、SSRI/SNRI 无反应者的 SAMe 辅助治疗试验中,SAMe 辅助治疗与辅助安慰剂相比是否与更大的性功能改善相关。
在控制基线时的唤醒障碍程度以及研究过程中 HDRS-17 量表评分的变化程度的情况下,接受 SAMe 辅助治疗的男性在终点时的唤醒障碍明显低于接受辅助安慰剂的男性。此外,在控制基线时的勃起功能障碍程度以及 HDRS-17 量表评分的变化程度的情况下,接受 SAMe 辅助治疗的男性在终点时的勃起功能障碍明显低于接受辅助安慰剂的男性。
在本研究中,我们观察到辅助 SAMe 可以对男性的唤醒和勃起功能障碍产生积极的益处,而与抑郁症状的改善无关。这些发现是初步的,需要进一步验证。临床试验注册标识:NCT00093847;题为“优化选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗难治性抑郁症的疗效”,可在以下网址获取:http://clinicaltrials.gov/ct2/show/NCT00093847。