Fabre-Kramer Pharmaceuticals, Houston, TX 77057, USA.
J Sex Med. 2011 Sep;8(9):2569-81. doi: 10.1111/j.1743-6109.2011.02330.x. Epub 2011 Jun 27.
Gepirone-extended release (ER) is effective in treating hypoactive sexual desire disorder (HSDD), as measured by the percent of females with HSDD that no longer met criteria for HSDD treatment. Another approach is to determine treatment effect on sexual desire using a recognized rating scale for sexual function. Because gepirone-ER has antidepressant and anxiolytic effects, investigation of these effects on sexual desire is appropriate.
The aim of this study was to determine whether gepirone-ER has positive effects on sexual desire as measured by the DeRogatis Inventory of Sexual Function (DISF) in a post hoc analysis of 8- and 24-week studies and if this gepirone effect is independent of its antidepressant or anxiolytic activity.
The main outcome measures used for this study were the Hamilton Depression Rating Scale (HAMD-25), change from baseline (CFB), and DISF CFB.
Three hundred thirty-four women selected for depressive symptoms, not sexual dysfunction, received gepirone-ER (40-80 mg/day) in a controlled study of atypical depression using the HAMD-25 to measure antidepressant efficacy and a DISF subscale (domain I) to measure sexual cognition/fantasy (desire). After treatment, a 50% reduction from baseline HAMD-25 score identified antidepressant responders. Item 12 of HAMD scale (psychic anxiety) was used to define anxiolytic response scores of 0, 1 as responders, and scores of 2, 3, and 4 as nonresponders.
Gepirone-ER had no significant antidepressant or an anxiolytic effect in study 134006; however, DISF results demonstrate that gepirone-ER improves sexual desire in short term (P=0.043) and long term (P=0.006). Both gepirone-ER antidepressant and anxiolytic responders have statistically significant improved sexual desire. Gepirone-ER antidepressant and anxiolytic nonresponders also show statistically significant improvement.
In depressed women, gepirone-ER has three mechanisms of action affecting sexual desire: an antidepressant effect, an anxiolytic effect, and a pro-sexual effect. Gepirone-ER improves sexual desire from the 24th to the 50th percentile according to population norms for the DISF.
吉哌隆延长释放（ER）在治疗女性性欲减退障碍（HSDD）方面是有效的，其疗效可通过 HSDD 治疗不再符合标准的女性比例来衡量。另一种方法是使用公认的性功能评定量表来确定对性欲的治疗效果。由于吉哌隆具有抗抑郁和抗焦虑作用，因此研究这些作用对性欲的影响是恰当的。
本研究旨在通过事后分析 8 周和 24 周的研究，确定吉哌隆 ER 是否对性欲有积极影响，使用 DeRogatis 性功能问卷（DISF）进行衡量，以及这种吉哌隆作用是否与其抗抑郁或抗焦虑活性无关。
本研究的主要观察指标为汉密尔顿抑郁量表（HAMD-25）、从基线的变化（CFB）和 DISF CFB。
选择 334 名有抑郁症状但无性功能障碍的女性，接受吉哌隆 ER（40-80mg/天）治疗，采用 HAMD-25 评估抗抑郁疗效，采用 DISF 亚量表（域 I）评估性认知/幻想（欲望）。治疗后，HAMD-25 评分降低 50%可识别出抗抑郁反应者。HAMD 量表的第 12 项（精神焦虑）用于定义焦虑反应评分 0、1 为反应者，评分 2、3 和 4 为非反应者。
在研究 134006 中，吉哌隆 ER 没有明显的抗抑郁或抗焦虑作用；然而，DISF 结果表明，吉哌隆 ER 可在短期（P=0.043）和长期（P=0.006）改善性欲。吉哌隆 ER 的抗抑郁和抗焦虑反应者的性欲均有统计学显著改善。吉哌隆 ER 的抗抑郁和抗焦虑非反应者也显示出统计学上显著的改善。
在抑郁女性中，吉哌隆 ER 有三种作用机制影响性欲：抗抑郁作用、抗焦虑作用和促性作用。根据 DISF 的人群正常范围，吉哌隆 ER 可将性欲从第 24 百分位提高到第 50 百分位。
