Signerski-Krieger Jörg, Schleifenbaum Lara
Klinik für Psychiatrie und Psychotherapie, Asklepios Fachklinikum Tiefenbrunn, Deutschland37124, Rosdorf, Deutschland.
Psychiatrische Klinik, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Nervenarzt. 2025 Mar;96(2):153-158. doi: 10.1007/s00115-025-01798-7. Epub 2025 Jan 28.
Disorders of sexual function are a frequent comorbidity of depression and have complex interactions on psychological, sexual and relationship qualities.
To determine the prevalence of sexual functional disorders in depressed patients, the effects of antidepressant drugs and development of treatment recommendations.
Evaluation of the current literature and discussion of fundamental studies.
Depression and sexual dysfunction frequently affect each other in complex ways which makes it important to address interpersonal relationship dynamics and to include these in the therapy. The use of serotonergic antidepressants can greatly increase the risk for sexual dysfunction by up to 27 times. In addition to (couples) therapeutic interventions, reducing the dose or switching medications to, e.g., bupropion or using additive medications can also be treatment options.
Despite the shame associated with the topic, it is crucial for therapists to address sexual topics early and openly. Relationship dynamics should be considered during therapy. If antidepressant medications are used it is recommended to provide a more detailed clarification for patients about their potential sexual side effects and their limited treatment options before starting the medication.
性功能障碍是抑郁症常见的共病，在心理、性及人际关系质量方面存在复杂的相互作用。
确定抑郁症患者性功能障碍的患病率、抗抑郁药物的影响并制定治疗建议。
对当前文献进行评估并讨论基础研究。
抑郁症和性功能障碍常以复杂方式相互影响，这使得处理人际关系动态并将其纳入治疗很重要。使用血清素能抗抑郁药会使性功能障碍风险大幅增加多达27倍。除了（夫妻）治疗干预外，减少剂量或换用如安非他酮等药物或使用辅助药物也可作为治疗选择。
尽管该话题令人感到羞耻，但治疗师尽早且公开地讨论性话题至关重要。治疗期间应考虑人际关系动态。如果使用抗抑郁药物，建议在开始用药前向患者更详细地说明其潜在的性副作用及有限的治疗选择。
