Graf Heiko, Walter Martin, Metzger Coraline D, Abler Birgit
Department of Psychiatry, Ulm University, Leimgrubenweg 12-14, 89075 Ulm, Germany.
Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Brenneckestraße 6, 39118 Magdeburg, Germany; Leibniz Institute for Neurobiology, Brenneckestraße 6, 39118 Magdeburg, Germany.
Pharmacol Biochem Behav. 2014 Jun;121:138-45. doi: 10.1016/j.pbb.2013.12.003. Epub 2013 Dec 11.
Sexual dysfunction is not only a common symptom in major depression but also a frequent side-effect of antidepressant medication, mainly of the selective serotonin reuptake-inhibitors (SSRI) that are often prescribed as a first line treatment option. Despite of the increasing incidence and prescription rates, neuronal mechanisms underlying SSRI-related sexual dysfunction are poorly understood and investigations on this topic are scarce. Neuroimaging techniques, mainly functional magnetic resonance imaging (fMRI), provide a feasible approach to investigate these mechanisms since SSRI-related sexual dysfunction is most likely related to central nervous processes. This review summarizes the recent literature regarding the basic clinical findings and imaging correlates of antidepressant-related sexual dysfunction linking brain regions and networks potentially involved to phases and subcomponents of sexual processing and antidepressant action. In particular, fMRI studies on SSRI antidepressants including paroxetine and SNRIs including bupropion are highlighted.
性功能障碍不仅是重度抑郁症的常见症状，也是抗抑郁药物的常见副作用，主要是选择性5-羟色胺再摄取抑制剂（SSRI）的副作用，而SSRI常被作为一线治疗药物。尽管发病率和处方率不断上升，但对SSRI相关性性功能障碍的神经机制了解甚少，关于这一主题的研究也很匮乏。神经影像学技术，主要是功能磁共振成像（fMRI），为研究这些机制提供了一种可行的方法，因为SSRI相关性性功能障碍很可能与中枢神经过程有关。这篇综述总结了最近有关抗抑郁药相关性性功能障碍的基本临床发现及影像学关联的文献，将潜在涉及的脑区和神经网络与性活动过程及抗抑郁作用的阶段和子成分联系起来。特别是，重点介绍了关于包括帕罗西汀在内的SSRI抗抑郁药和包括安非他酮在内的5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）的fMRI研究。
