Ruiz-Santiago Carolina, Rodríguez-Pinacho Carla Valeria, Pérez-Sánchez Gilberto, Acosta-Cruz Erika
Department of Biotechnology, Faculty of Chemistry, Universidad Autónoma de Coahuila, Saltillo Coahuila 25280, México.
Laboratory of Psychoimmunology, National Institute of Psychiatry Ramón de la Fuente Muñíz, México City 14370, México.
Biomed Rep. 2024 Jul 5;21(3):128. doi: 10.3892/br.2024.1816. eCollection 2024 Sep.
Selective serotonin reuptake inhibitors (SSRIs) are typically prescribed for treating major depressive disorder (MDD) due to their high efficacy. These drugs function by inhibiting the reuptake of serotonin [also termed 5-hydroxytryptamine (5-HT)], which raises the levels of 5-HT in the synaptic cleft, leading to prolonged activation of postsynaptic 5-HT receptors. Despite the therapeutic benefits of SSRIs, this mechanism of action also disturbs the neuroendocrine response. Hypothalamic-pituitary-adrenal (HPA) axis activity is strongly linked to both MDD and the response to antidepressants, owing to the intricate interplay within the serotonergic system, which regulates feeding, water intake, sexual drive, reproduction and circadian rhythms. The aim of the present review was to provide up-to-date evidence for the proposed effects of SSRIs, such as fluoxetine, citalopram, escitalopram, paroxetine, sertraline and fluvoxamine, on the endocrine system. For this purpose, the literature related to the effects of SSRIs on the endocrine system was searched using the PubMed database. According to the available literature, SSRIs may have an adverse effect on glucose metabolism, sexual function and fertility by dysregulating the function of the HPA axis, pancreas and gonads. Therefore, considering that SSRIs are often prescribed for extended periods, it is crucial to monitor the patient closely with particular attention to the function of the endocrine system.
选择性5-羟色胺再摄取抑制剂（SSRIs）因其高效性，通常被用于治疗重度抑郁症（MDD）。这些药物通过抑制5-羟色胺（也称为5-羟色氨酸，5-HT）的再摄取来发挥作用，从而提高突触间隙中5-HT的水平，导致突触后5-HT受体的持续激活。尽管SSRIs具有治疗作用，但其作用机制也会干扰神经内分泌反应。下丘脑-垂体-肾上腺（HPA）轴的活动与MDD以及对抗抑郁药的反应密切相关，这是由于5-羟色胺能系统内部存在复杂的相互作用，该系统调节进食、饮水、性欲、生殖和昼夜节律。本综述的目的是提供最新证据，证明氟西汀、西酞普兰、艾司西酞普兰、帕罗西汀、舍曲林和氟伏沙明等SSRIs对内分泌系统的影响。为此，使用PubMed数据库搜索了与SSRIs对内分泌系统影响相关的文献。根据现有文献，SSRIs可能通过调节HPA轴、胰腺和性腺的功能，对糖代谢、性功能和生育能力产生不利影响。因此，鉴于SSRIs通常需要长期服用，密切监测患者并特别关注内分泌系统的功能至关重要。
