Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ther Adv Psychopharmacol. 2013 Dec;3(6):306-13. doi: 10.1177/2045125313488906.
Depression is one of the most common psychiatric disorders in the world. Lifetime prevalence is 15% among men and 25% among women. Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants and monoamine oxidase inhibitor antidepressants are often used for depression, with their own side effects. This study was carried out since little information on sexual dysfunction due to these medications is available in Iran.
This observational cross-sectional study included 100 patients attending a university or private psychiatry clinic who, after an interview based on Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria, were considered depressed. These patients had no history of depression, sexual dysfunction or use of psychiatric medications. Sexual functioning of patients was evaluated at the start of the study, and after 2, 4 and 8 weeks of treatment. Data were evaluated using SPSS software and t and χ(2) tests.
A total of 75% of patients reported sexual dysfunction: 66.7% of men and 79.7% of women. A total of 74.1% of patients on fluvoxamine, 100% on fluoxetine, 75% on sertraline, 71.4% on citalopram and 100% on paroxetine reported sexual dysfunction. The most frequent sexual dysfunction was difficulty with orgasm, which affected 41.17% of women and 33.33% of men.
The incidence of sexual dysfunction among users of SSRIs was highest in patients on fluvoxamine, but this was not statistically significant. Minimization of sexual side effects should be an essential consideration when prescribing antidepressants.
抑郁症是世界上最常见的精神障碍之一。男性终身患病率为 15%，女性为 25%。选择性 5-羟色胺再摄取抑制剂（SSRIs）、三环类抗抑郁药和单胺氧化酶抑制剂抗抑郁药常用于治疗抑郁症，但都有其自身的副作用。由于伊朗对这些药物引起的性功能障碍的信息较少，因此进行了这项研究。
这项观察性横断面研究纳入了 100 名在大学或私人精神病诊所就诊的患者，他们在根据《精神障碍诊断与统计手册》第四版标准进行访谈后被认为患有抑郁症。这些患者没有抑郁症、性功能障碍或使用精神科药物的病史。在研究开始时和治疗后 2、4 和 8 周评估患者的性功能。使用 SPSS 软件和 t 检验和 χ²检验评估数据。
共有 75%的患者报告存在性功能障碍：男性为 66.7%，女性为 79.7%。服用氟伏沙明的患者中有 74.1%、氟西汀有 100%、舍曲林有 75%、西酞普兰有 71.4%和帕罗西汀有 100%报告存在性功能障碍。最常见的性功能障碍是性高潮困难，影响了 41.17%的女性和 33.33%的男性。
SSRIs 使用者中性功能障碍的发生率以服用氟伏沙明的患者最高，但这并无统计学意义。在开处方时，应充分考虑减少抗抑郁药的性副作用。
