Álvarez-Silva Adriana, Rodríguez-Manzo Gabriela, Reyes Rebeca, Fernández-Guasti Alonso
Departamento de Farmacobiología, Sede sur, Cinvestav, Mexico.
Psychopharmacology (Berl). 2025 Jan;242(1):189-204. doi: 10.1007/s00213-024-06661-2. Epub 2024 Aug 7.
Pharmacological treatments for depression are not always effective and produce unwanted side effects. Male and female sexual dysfunction is one of these side effects, which can lead to treatment withdrawal. Combination of two antidepressants with different mechanisms of action, like mirtazapine (MTZ) and venlafaxine (VLF) have been shown to be effective for treatment-resistant depression in humans. Combination of low doses of these drugs may still exert antidepressant-like effects without altering sexual behavior.
To investigate the potential antidepressant-like effect of the chronic administration of low doses of MTZ plus VLF combined, as well as its impact on male and female sexual behavior in rats.
The antidepressant-like effect of a 14-day treatment with combinations of MTZ plus VLF (0/0, 2.5/3.75 or 5/7.5 mg/kg) was assessed in young adult male and female rats in the forced swim test (FST). The 5/7.5 mg/kg MTZ/VLF combination was also tested in the chronic mild stress (CMS) test, in both males and females treated for 21 days. The sexual effects of this last treatment were assessed in sexually experienced males and in gonadally-intact females during proestrus.
The 5/7.5 mg/kg MTZ/VLF combination produced an antidepressant-like effect in the FST and reversed the CMS-induced anhedonia in both male and female rats. This combination did not alter male sexual behavior, female proceptive and receptive behaviors or the regularity of the estrous cycle.
The combination of low doses of MTZ and VLF might be a promising therapeutic alternative to treat depression without affecting the sexual response.
抑郁症的药物治疗并非总是有效,且会产生不良副作用。男性和女性性功能障碍就是其中一种副作用,可能导致治疗中断。两种作用机制不同的抗抑郁药联合使用,如米氮平(MTZ)和文拉法辛(VLF),已被证明对难治性抑郁症患者有效。低剂量联合使用这些药物仍可能发挥抗抑郁样作用,且不改变性行为。
研究低剂量MTZ与VLF长期联合给药的潜在抗抑郁样作用及其对大鼠雄雌性行为的影响。
在成年雄性和雌性幼鼠的强迫游泳试验(FST)中,评估MTZ与VLF联合用药(0/0、2.5/3.75或5/7.5mg/kg)14天的抗抑郁样作用。还在接受21天治疗的雄性和雌性大鼠的慢性轻度应激(CMS)试验中测试了5/7.5mg/kg的MTZ/VLF联合用药。在性经验丰富的雄性大鼠和处于发情前期性腺完整的雌性大鼠中评估最后一种治疗的性效应。
5/7.5mg/kg的MTZ/VLF联合用药在FST中产生了抗抑郁样作用,并逆转了CMS诱导的雄性和雌性大鼠快感缺失。这种联合用药未改变雄性性行为、雌性的求偶和接受行为或发情周期的规律性。
低剂量MTZ和VLF联合使用可能是一种有前景的治疗抑郁症的替代方法,且不影响性反应。