U.O. di Psichiatria, Ospedale di Rovereto, Rovereto (Tn), Italy.
Pharmacopsychiatry. 2013 Sep;46(6):201-8. doi: 10.1055/s-0033-1347177. Epub 2013 Jun 4.
Sexual dysfunction is a potential side effect of antipsychotic drugs: this article presents a critical review of the current literature. Although many studies have been published on the subject, only some used a validated sexual function rating scale and most lacked either a baseline or placebo control or both. In addition, many of the studies on sexual dysfunction associated with antipsychotic medication are limited by other methodological flaws. However, there is consistent evidence to suggest that a large number of antipsychotic drugs adversely affect one or more of the 3 phases of sexual response (desire, arousal and orgasm). Among the antipsychotics, the so called "prolactin-raising" are probably most associated with sexual dysfunction, even if further studies to confirm this are needed: the reviewed literature shows no consistent evidence that any one antipsychotic drug has a significantly superior side effect profile over another and current information on this topic is often based on methodologically weak research. Clinicians must be aware of drug-induced sexual dysfunction, since its presence can have important consequences for clinical management and compliance.
本文对当前文献进行了批判性回顾。尽管已经发表了许多关于该主题的研究,但只有一些研究使用了经过验证的性功能评分量表,而且大多数研究要么缺乏基线或安慰剂对照,要么两者都缺乏。此外,许多关于与抗精神病药物相关的性功能障碍的研究还受到其他方法学缺陷的限制。然而,有一致的证据表明,大量抗精神病药物会对性反应的 3 个阶段(欲望、唤起和高潮)中的一个或多个阶段产生不利影响。在抗精神病药物中,所谓的“催乳素升高”药物可能与性功能障碍的关系最密切,尽管还需要进一步的研究来证实这一点:回顾的文献没有一致的证据表明任何一种抗精神病药物在副作用方面明显优于另一种,目前关于这个主题的信息通常基于方法学上较弱的研究。临床医生必须意识到药物引起的性功能障碍,因为它的存在可能对临床管理和依从性产生重要影响。