Karaş Hakan, Kaşer Muzaffer
Turk Psikiyatri Derg. 2019 Summer;30(2):142-144.
Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient.
勃起功能障碍是一种性功能障碍，通常与重度抑郁症共病。抗抑郁治疗并不总能改善重度抑郁症中共病的性功能障碍。事实上，在使用抗抑郁药后，性功能障碍可能会恶化或变得复杂。莫达非尼是一种通过与去甲肾上腺素和多巴胺转运体结合，从而增加突触去甲肾上腺素和多巴胺水平，对中枢神经系统有刺激作用的药物。莫达非尼主要用于治疗发作性睡病和慢性疲劳综合征。此外，它在注意力缺陷多动障碍方面的有效性以及作为重度抑郁症的附加治疗选择而闻名。在本文中，我们报告了一例39岁重度抑郁症男性患者的病例，在抗抑郁治疗中加用莫达非尼后，其共病的勃起功能障碍得到改善。开始使用氟西汀20毫克/天，尽管大多数抑郁症状和性欲有所改善，但他仍抱怨疲劳、虚弱和勃起功能障碍。加用莫达非尼（200毫克/天）后，不仅观察到患者精神运动症状有所改善，勃起功能障碍也有所改善。
