Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Sex Med. 2014 Jan;11(1):22-32. doi: 10.1111/jsm.12352. Epub 2013 Oct 28.
For many years, methadone has been recognized as an effective maintenance treatment for opioid dependence. However, of the many adverse events reported, sexual dysfunction is one of the most common side effects.
We conducted a meta-analysis to evaluate the prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments.
Relevant studies published from inception until December 2012 were identified by searching PubMed, OVID, and Embase. Studies were selected using prior defined criteria. Heterogeneity, publication bias, and odds ratio were assessed thoroughly.
To examine the prevalence and odds ratio of sexual dysfunctions among the methadone and buprenorphine groups.
A total of 1,570 participants from 16 eligible studies were identified in this meta-analysis. The studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval [CI], 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (OR = 4.01, 95% CI, 1.52-10.55, P = 0.0049).
Evidence showed that the prevalence of sexual dysfunction was higher among the users of methadone compared with buprenorphine. Patients with sexual difficulty while on methadone treatment were advised to switch to buprenorphine.
多年来,美沙酮一直被认为是治疗阿片类药物依赖的有效维持治疗方法。然而,在报告的许多不良反应中,性功能障碍是最常见的副作用之一。
我们进行了一项荟萃分析,以评估美沙酮和丁丙诺啡治疗的男性患者性功能障碍的患病率。
通过搜索 PubMed、OVID 和 Embase,确定了从开始到 2012 年 12 月发表的相关研究。使用预先定义的标准选择研究。彻底评估了异质性、发表偏倚和优势比。
检查美沙酮和丁丙诺啡组性功能障碍的患病率和优势比。
这项荟萃分析共纳入了 16 项合格研究的 1570 名参与者。这些研究提供了美沙酮使用者性功能障碍的患病率估计值,荟萃分析汇总的患病率为 52%(95%置信区间,0.39-0.65)。只有四项研究比较了两组之间的性功能障碍,美沙酮组的联合优势比显著更高(OR=4.01,95%CI,1.52-10.55,P=0.0049)。
证据表明,美沙酮使用者性功能障碍的患病率高于丁丙诺啡使用者。建议在美沙酮治疗时出现性功能困难的患者改用丁丙诺啡。