Espinola Caroline W, Khoo Yuelee, Parmar Roohie, Demchenko Ilya, Frey Benicio N, Milev Roumen V, Ravindran Arun V, Parikh Sagar V, Ho Keith, Rotzinger Susan, Lou Wendy, Lam Raymond W, Kennedy Sidney H, Bhat Venkat
Interventional Psychiatry Program, Centre for Depression & Suicide Studies, St. Michael's Hospital, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
J Psychopharmacol. 2022 May;36(5):604-613. doi: 10.1177/02698811221095832. Epub 2022 May 12.
Antidepressant use for major depressive disorder (MDD) is frequently associated with sexual dysfunction.
Cross-sectional and longitudinal relationships between antidepressant treatment outcomes and sexual functioning (SF) were evaluated separately for males and females receiving escitalopram. We further assessed the association between pre- and posttreatment SF.
In all, 208 of the 211 CAN-BIND-1 trial participants (77 males and 131 females) with MDD and detectable drug blood levels were eligible for the analyses. All received escitalopram (10-20 mg) for 8 weeks. At baseline and Week 8, participants completed the Montgomery-Åsberg Depression Rating Scale (MADRS) and the SexFx scale, which measures sexual satisfaction and SF frequency. Mixed-model repeated measures assessed baseline to Week 8 SF changes among participants with different response/remission statuses. Multiple linear regression analyses examined SF differences between treatment outcomes at Week 8 as well as associations between pretreatment and eventual SF.
For both sexes, overall sexual satisfaction improved among responders but not among nonresponders ( < 0.05). For females, overall SF frequency did not change significantly over time regardless of response status. For males, overall SF decreased significantly among nonresponders; orgasm decreased significantly among nonresponders and, to a lesser extent, among responders ( < 0.05). For both sexes, pretreatment SF was significantly associated with SF at Week 8 across all domains ( < 0.05).
For both sexes, sexual satisfaction improves with response to escitalopram. For females, the response does not correspond to improvements in SF frequency. For males, SF frequency, particularly that of orgasm, declines regardless of response/nonresponse.ClinicalTrials.gov identifier: NCT01655706.
抗抑郁药用于治疗重度抑郁症（MDD）时常常与性功能障碍相关。
分别评估接受艾司西酞普兰治疗的男性和女性中，抗抑郁治疗效果与性功能（SF）之间的横断面和纵向关系。我们还进一步评估了治疗前后性功能之间的关联。
在CAN - BIND - 1试验的211名参与者中，共有208名患有MDD且药物血药浓度可检测的参与者（77名男性和131名女性）符合分析条件。所有人均接受艾司西酞普兰（10 - 20毫克）治疗8周。在基线和第8周时，参与者完成蒙哥马利 - 阿斯伯格抑郁评定量表（MADRS）和性福量表（SexFx），该量表测量性满意度和性功能频率。混合模型重复测量评估了不同反应/缓解状态的参与者从基线到第8周性功能的变化。多元线性回归分析检查了第8周治疗效果之间的性功能差异以及治疗前与最终性功能之间的关联。
对于男女两性，有反应者的总体性满意度有所提高，而无反应者则未提高（<0.05）。对于女性，无论反应状态如何，总体性功能频率随时间没有显著变化。对于男性，无反应者的总体性功能显著下降；无反应者的性高潮显著下降，有反应者也有一定程度下降（<0.
