Psichiatria, Ospedale di Rovereto, Rovereto, Italy.
Psychiatrie, S Maurizio Hospital, Bolzano, Italy.
Pharmacopsychiatry. 2014 Jan;47(1):1-6. doi: 10.1055/s-0033-1358683. Epub 2013 Nov 12.
Sexual dysfunction is a potential side effect of mood stabilizers and anxiolytic drugs: this article presents a critical review of the current literature. Although many studies have been published on sexual side effects of psychopharmacological treatment, only a minority relate to mood stabilizers and anxiolytic drugs. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, many of the studies on sexual dysfunction associated with mood stabilizers and anxiolytic drugs are limited by other methodological flaws. While there is evidence to suggest that mood stabilizers, with some exceptions, negatively affect sexual functioning, there is still insufficient evidence to draw any clear conclusions about the effects of anxiolytic drugs on sexual function. There is some weak evidence to indicate that switching from enzyme-inducing to non-enzyme-inducing anticonvulsant drugs, could be clinically useful. Some researchers recommend that sexual dysfunction in patients taking antiepileptic drugs should in general be treated according to standard guidelines for the management of sexual dysfunction, since reliable data on special populations is not available. However, specific approaches may be useful, but cannot yet be recommended until further validating research has been conducted. We did not find evidence supporting the use of any specific treatment strategy for sexual dysfunction associated with anxiolytic treatment.
This study was conducted in 2013 using the paper and electronic resources of the library of the Azienda Provinciale per i Servizi Sanitari (APSS) in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793, or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words "anxiolytic drugs", "mood stabilizers", "benzodiazepines", "psychotrophic drugs", "sexual dysfunction", "sexual side effects", "treatment-emergent sexual dysfunction". All resulting listed articles were reviewed.
This review includes studies that investigated the relationship between mood stabilizer and anxiolytic drug treatment and sexual dysfunction. The purpose was to identify possible intervention strategies for sexual dysfunction related to these drugs.
性障碍是心境稳定剂和抗焦虑药物的潜在副作用：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精神药理学治疗的性副作用的研究，但只有少数研究与心境稳定剂和抗焦虑药物有关。这些研究大多方法学上不严谨，少数为 RCT，且大多数未使用经过验证的评定量表来评估性功能。此外，许多关于心境稳定剂和抗焦虑药物相关性功能障碍的研究受到其他方法学缺陷的限制。虽然有证据表明，除了一些例外情况外，心境稳定剂会对性功能产生负面影响，但仍缺乏明确结论来确定抗焦虑药物对性功能的影响。有一些微弱的证据表明，从酶诱导型抗癫痫药物转换为非酶诱导型抗癫痫药物可能具有临床意义。一些研究人员建议，对于正在服用抗癫痫药物的患者的性功能障碍，一般应根据性功能障碍管理的标准指南进行治疗，因为目前尚无针对特殊人群的可靠数据。然而，特定方法可能是有用的，但在进行进一步验证研究之前，无法推荐使用。我们没有发现任何证据支持使用任何特定的治疗策略来治疗与抗焦虑治疗相关的性功能障碍。
本研究于 2013 年使用意大利特伦托省卫生局（APSS）的图书馆的纸质和电子资源（http://atoz.ebsco.com/Titles/2793）进行。该图书馆可以访问包括 DYNAMED、MEDLINE Full Text、CINAHL Plus Full Text、The Cochrane Library、Micromedex healthcare series、BMJ Clinical Evidence 在内的广泛数据库。可在 http://atoz.ebsco.com/Titles/2793 或在 APSS 网站（http://www.apss.tn.it）上查看可用期刊的完整列表。在完成这项研究时，使用了“抗焦虑药物”、“心境稳定剂”、“苯二氮䓬类”、“精神药物”、“性功能障碍”、“性功能副作用”、“治疗后出现的性功能障碍”等关键词进行了文献检索。对所有列出的文章进行了综述。
本综述包括了研究心境稳定剂和抗焦虑药物治疗与性功能障碍之间关系的研究。目的是确定这些药物相关性功能障碍的可能干预策略。
