Gałecki Piotr, Florkowski Antoni, Depko Andrzej, Woźniak Aneta, Talarowska Monika
Department of Adult Psychiatry, Medical University of Łódź, Poland.
Pol Merkur Lekarski. 2011 Sep;31(183):193-6.
Sexual dysfunction in patients diagnosed with depressive disorders affect all phases of sexual response: a decline in libido, erectile dysfunction, ejaculation disorders in men and orgasm and menstruation in women. It is estimated that are present in approximately 70% of patients, affecting 23-50% of men suffering from depression and 33-90% of women. The most common symptoms include disorders of sexual arousal in women (usually in the form of excessive vaginal dryness), erectile dysfunction in men and affects both sexes abnormal orgasm (anorgasmia or delayed). Sexual dysfunction is treated as a potential side effect of antidepressant therapy. These drugs can exacerbate the symptoms of primary sexual dysfunction, and induce it in those patients who were not present before treatment. Symptoms of sexual dysfunction reduces quality of life, self-esteem, mood, and negatively affect the relationship with your partner. Most currently used antidepressants in the world leads to the occurrence of sexual dysfunction. These include monoamine oxidase inhibitors, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin reuptake inhibitors and norepinephrine, and a new generation of antidepressants. SSRIs are considered to be preparations for the largest iatrogenic effect. Sexual dysfunction resulting from treatment with antidepressant among the most serious reasons for discontinuation by the patients.
被诊断患有抑郁症的患者出现性功能障碍，会影响性反应的各个阶段：性欲下降、勃起功能障碍、男性射精障碍以及女性性高潮和月经问题。据估计，约70%的患者存在性功能障碍，其中23% - 50%的男性抑郁症患者以及33% - 90%的女性抑郁症患者受其影响。最常见的症状包括女性性唤起障碍（通常表现为阴道过度干涩）、男性勃起功能障碍以及影响两性的异常性高潮（性高潮缺失或延迟）。性功能障碍被视为抗抑郁治疗的潜在副作用。这些药物会加重原发性性功能障碍的症状，并在治疗前不存在该问题的患者中诱发此症状。性功能障碍症状会降低生活质量、自尊、情绪，并对与伴侣的关系产生负面影响。目前世界上大多数使用的抗抑郁药都会导致性功能障碍的发生。这些药物包括单胺氧化酶抑制剂、三环类抗抑郁药、5-羟色胺再摄取抑制剂、5-羟色胺再摄取抑制剂和去甲肾上腺素，以及新一代抗抑郁药。5-羟色胺再摄取抑制剂被认为是医源性影响最大的制剂。抗抑郁药治疗导致的性功能障碍是患者停药的最严重原因之一。
