Addictology and Psychiatry Department, CHU Nantes, 44093 Nantes, France.
Inserm UMR-1246, Université de Nantes, Université de Tours, 44200 Nantes, France.
Int J Mol Sci. 2020 Apr 24;21(8):3002. doi: 10.3390/ijms21083002.
Hypersexuality is a well-known adverse side effect of dopamine replacement therapy (DRT), and anti-craving drugs could be an effective therapeutic option. Our aim was to update the knowledge on this issue, particularly on the influence of an Opioid Receptor Mu 1 () genetic polymorphism. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We also analyzed a case of iatrogenic hypersexuality that occurred in a patient treated with DRT. An analysis of the gene was performed on said patient. Our search identified 597 publications, of which only 7 were included in the final data synthesis. All seven publications involved naltrexone use. Five of them were case reports. None of the publications mentioned DRT side effects, nor did they report genetic data. Regarding our case report, the introduction of naltrexone corresponded with the resolution of the patient's hypersexuality. Moreover, the patient carried the A/G genotype, which has been reported to be associated with a stronger response to naltrexone for patients with an alcohol use disorder. Although studies are inconclusive so far, naltrexone could be an interesting therapeutic option for resistant hypersexuality due to DRT. Carrying the A/G genotype could help explain a good response to treatment.
性亢奋是多巴胺替代疗法(DRT)已知的不良反应,而抗成瘾药物可能是一种有效的治疗选择。我们的目的是更新关于这个问题的知识,特别是关于阿片受体 Mu1()基因多态性的影响。根据系统评价和荟萃分析的首选报告项目(PRISMA)声明进行了系统评价。我们还分析了一名接受 DRT 治疗的患者发生的医源性性亢奋病例。对该患者进行了基因分析。我们的搜索确定了 597 篇出版物,其中只有 7 篇被纳入最终数据综合分析。所有七篇出版物都涉及纳曲酮的使用。其中有五篇是病例报告。没有一篇出版物提到 DRT 的副作用,也没有报告遗传数据。关于我们的病例报告,纳曲酮的引入与患者性亢奋的缓解相对应。此外,该患者携带 A/G 基因型,据报道,该基因型与酒精使用障碍患者对纳曲酮的反应更强相关。尽管目前的研究尚无定论,但纳曲酮可能是治疗 DRT 引起的耐药性性亢奋的一个有趣的治疗选择。携带 A/G 基因型可能有助于解释对治疗的良好反应。