Zahiroddin Alireza, Faridhosseini Farhad, Zamani Azar, Shahini Najmeh
Behavioral Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Iran Red Crescent Med J. 2015 Dec 5;17(12):e24998. doi: 10.5812/ircmj.24998. eCollection 2015 Dec.
Antidepressant-induced sexual dysfunction (SD) is a common problem, associated with a significant risk of non-adherence. Selective Serotonin Reuptake Inhibitors (SSRIs) are associated with a substantial risk of SD. Only 10 % of patients show spontaneous improvement during follow up period.
This study aimed to compare two proposed medication (bupropion vs. amantadine) in alleviating SD in patients treated with SSRIs.
In a randomized, single-blinded, clinical trial in Iran, 46 patients were recruited based on DSM-IV-TR criteria and semi-structured interview. Then, they were randomized into two treatment groups using table of random numbers. Eight patients were excluded and finally 38 patients completed the study which lasted for 4 weeks. Twenty patients were given bupropion, 18 patients were randomly assigned to another group, and given amantadine. Patients were assessed with the Arizona sexual experience scale (ASEX) at baseline and 4 weeks after the treatment.
A total of 38 patients completed the study (18 patients in amantadine vs. 20 patients in bupropion).The mean ASEX scores gradually declined in both study groups during the trial. The reduction of ASEX score in bupropion group was more than that of amantadine group that was statistically significant. So, the addition of bupropion at higher doses appears to be more effective approach in comparison with amantadine.
These results provide empirical support for conducting a further study on comparing different add-on strategies for treating drug-induced SD.
抗抑郁药引起的性功能障碍(SD)是一个常见问题,与显著的不依从风险相关。选择性5-羟色胺再摄取抑制剂(SSRIs)与较高的SD风险相关。在随访期间,只有10%的患者出现自发改善。
本研究旨在比较两种推荐药物(安非他酮与金刚烷胺)在减轻接受SSRIs治疗患者的SD方面的效果。
在伊朗进行的一项随机、单盲临床试验中,根据《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)标准和半结构式访谈招募了46名患者。然后,使用随机数字表将他们随机分为两个治疗组。8名患者被排除,最终38名患者完成了为期4周的研究。20名患者服用安非他酮,18名患者被随机分配到另一组,服用金刚烷胺。在基线和治疗4周后,使用亚利桑那性体验量表(ASEX)对患者进行评估。
共有38名患者完成了研究(金刚烷胺组18名患者,安非他酮组20名患者)。在试验期间,两个研究组的ASEX平均得分均逐渐下降。安非他酮组的ASEX得分下降幅度大于金刚烷胺组,具有统计学意义。因此,与金刚烷胺相比,增加较高剂量的安非他酮似乎是更有效的方法。
这些结果为进一步研究比较治疗药物引起的SD的不同附加策略提供了实证支持。