University of Virginia, Charlottesville, VA 22908-062, USA.
J Sex Med. 2013 Mar;10(3):768-76. doi: 10.1111/j.1743-6109.2012.02899.x. Epub 2012 Aug 20.
The symptoms of major depressive disorder (MDD) include sexual dysfunction, but antidepressant pharmacotherapies are also associated with treatment-emergent sexual dysfunction.
These secondary and post hoc analyses evaluated sexual functioning in employed adult outpatients with MDD treated with desvenlafaxine (administered as desvenlafaxine succinate) and placebo.
Patients were randomly assigned (2:1 ratio) to 12 weeks of double-blind treatment with desvenlafaxine 50 mg/day or placebo.
The Arizona Sexual Experiences Scale (ASEX) was administered every 4 weeks. Analysis of covariance was used to compare differences in mean change from baseline ASEX scores between desvenlafaxine and placebo for women and men.
There were 422 evaluable patients with baseline ASEX scores (desvenlafaxine, N = 281; placebo, N = 141). Among women (desvenlafaxine, N = 184; placebo, N = 92), baseline scores were 20.0 (5.2) and 20.5 (5.3) for desvenlafaxine and placebo, respectively; mean changes at week 12 were -1.93 (0.37) and -1.03 (0.54), respectively (mean difference: 0.90 [-0.38, 2.18]; P = 0.169). Among men (desvenlafaxine, N = 97; placebo, N = 49), baseline scores were 16.4 (4.9) and 15.9 (4.8) for desvenlafaxine and placebo, respectively; mean changes at week 12 were -1.13 (0.47) and -1.06 (0.70), respectively (mean difference: 0.07 [-1.59, 1.74]; P = 0.932). Significantly greater orgasmic dysfunction at week 12 was observed in the subgroup of men without baseline sexual dysfunction treated with desvenlafaxine relative to placebo. Conversely, women without baseline sexual dysfunction experienced poorer overall sexual functioning and orgasm satisfaction at week 12 with placebo relative to desvenlafaxine treatment. Subgroup analyses of treatment responders and nonresponders found no difference in the proportion of men or women that developed or had resolution of sexual dysfunction in the desvenlafaxine and placebo groups.
With the exception of orgasmic dysfunction in men without preexisting sexual dysfunction, no significant negative effect on sexual functioning was observed over 12 weeks of treatment with desvenlafaxine.
重度抑郁症(MDD)的症状包括性功能障碍,但抗抑郁药治疗也与治疗后出现的性功能障碍有关。
这些次要和事后分析评估了接受文拉法辛(作为文拉法辛琥珀酸盐给药)和安慰剂治疗的 MDD 成年门诊患者的性功能。
患者被随机分配(2:1 比例)接受为期 12 周的双盲治疗,每天服用文拉法辛 50mg 或安慰剂。
每 4 周进行一次亚利桑那性经验量表(ASEX)评估。使用协方差分析比较文拉法辛和安慰剂组女性和男性的基线 ASEX 评分平均变化差异。
有 422 名可评估基线 ASEX 评分的患者(文拉法辛组,N=281;安慰剂组,N=141)。在女性中(文拉法辛组,N=184;安慰剂组,N=92),基线评分分别为 20.0(5.2)和 20.5(5.3);第 12 周的平均变化分别为-1.93(0.37)和-1.03(0.54)(平均差异:0.90[-0.38, 2.18];P=0.169)。在男性中(文拉法辛组,N=97;安慰剂组,N=49),基线评分分别为 16.4(4.9)和 15.9(4.8);第 12 周的平均变化分别为-1.13(0.47)和-1.06(0.70)(平均差异:0.07[-1.59, 1.74];P=0.932)。与安慰剂相比,基线无性功能障碍的男性中,第 12 周时观察到明显更大的性高潮障碍。相反,与文拉法辛治疗相比,基线无性功能障碍的女性在第 12 周时整体性功能和性高潮满意度更差。在治疗反应者和非反应者的亚组分析中,在文拉法辛和安慰剂组中,没有发现男性或女性在出现或解决性功能障碍方面的比例存在差异。
在接受文拉法辛治疗 12 周内,除了基线无性功能障碍的男性出现性高潮障碍外,未观察到对性功能的显著负面影响。