Mazzilli Rossella, Angeletti Gloria, Olana Soraya, Delfino Michele, Zamponi Virginia, Rapinesi Chiara, Del Casale Antonio, Kotzalidis Georgios D, Elia Jlenia, Callovini Gemma, Girardi Paolo, Mazzilli Fernando
Andrology Unit, Sant'Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome.
Arch Ital Urol Androl. 2018 Mar 31;90(1):44-48. doi: 10.4081/aiua.2018.1.44.
The aim of this study was to assess the prevalence of patients with Erectile Dysfunction (ED) receiving psychotropic drugs, the impact of these drugs on hormonal profile, and the efficacy of PDE5-i in these patients.
We recruited 1872 patients referring for ED to our Andrology Unit. Assessment included serum testosterone, gonadotropins, TSH, prolactin, and PSA, and the IIEF-5 questionnaire for ED diagnosis. Inclusion criteria were age 21-75 years and IIEF-5 total score ≤ 21; exclusion criteria included hypogonadism, diabetes mellitus, previous prostatectomy, other medication intake, and ED diagnosis prior to psychotropic drug treatment. Efficacy was rated with the IIEF-5 (remission: total score ≥ 22).
The prevalence of ED patients treated with psychotropic drugs since ≥ 3 months was 9.5% (178/1872), subdivided according to the drugs used into: Group A, 16 patients treated with atypical antipsychotics (9.0%); Group B, 55 patients with benzodiazepines (30.9%); Group C, 33 patients with antidepressant drugs (18.5%); and Group D, 74 patients with multiple psychotropic drugs (41.6%). Patients in Group A were significantly younger than other groups (p < 0.05). The hormonal profile presented only higher prolactin level in patients treated with antipsychotics, alone or in combination (p < 0.05). Overall, 146 patients received PDE5-i. Remission rate, after three months of treatment, was significantly higher in Group B compared to C and D groups (p < 0.05).
A substantial portion of patients receiving psychotropic drugs show ED. Sexual performance in these patients benefits from PDE5-i. Age, effects of psychiatric disorders, psychotropic drugs, and PDE5-i treatment modality accounted for variability of response in this sample.
本研究旨在评估接受精神药物治疗的勃起功能障碍（ED）患者的患病率、这些药物对激素水平的影响以及磷酸二酯酶5抑制剂（PDE5-i）在这些患者中的疗效。
我们招募了1872名因ED前来男科门诊就诊的患者。评估项目包括血清睾酮、促性腺激素、促甲状腺激素、催乳素和前列腺特异抗原，以及用于ED诊断的国际勃起功能指数-5（IIEF-5）问卷。纳入标准为年龄21-75岁且IIEF-5总分≤21；排除标准包括性腺功能减退、糖尿病、既往前列腺切除术、正在服用其他药物以及在接受精神药物治疗前已诊断为ED。疗效通过IIEF-5进行评估（缓解：总分≥22）。
接受精神药物治疗≥3个月的ED患者患病率为9.5%（178/1872），根据所使用的药物分为：A组，16名接受非典型抗精神病药物治疗的患者（9.0%）；B组，55名使用苯二氮䓬类药物的患者（30.9%）；C组，33名使用抗抑郁药物的患者（18.5%）；D组，74名使用多种精神药物的患者（41.6%）。A组患者明显比其他组年轻（p<0.05）。仅在单独或联合使用抗精神病药物治疗的患者中，激素水平表现为催乳素水平较高（p<0.05）。总体而言，146名患者接受了PDE5-i治疗。治疗三个月后，B组的缓解率显著高于C组和D组（p<0.05）。
相当一部分接受精神药物治疗的患者存在ED。这些患者的性功能可从PDE5-i治疗中获益。年龄、精神疾病的影响、精神药物以及PDE5-i治疗方式导致了本样本中反应的变异性。
