Bieś Rafał, Szewczyk Zuzanna, Warchala Anna, Martyniak Ewa, Krzystanek Marek
Doctoral School, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia, Ziołowa 45/47, 40-635 Katowice, Poland.
Medical Students' Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, Poland.
Pharmaceuticals (Basel). 2025 May 14;18(5):718. doi: 10.3390/ph18050718.
Methylphenidate is a psychostimulant that enhances dopamine and norepinephrine neurotransmission through the mechanism of reuptake inhibition at the synaptic cleft. Studies indicate that sexual dysfunction is prevalent among psychiatric patients. The objective of our study was to assess the impact of methylphenidate on patients' sexual health, identify specific types of sexual dysfunction, and analyse the correlations between psychiatric disorders, treatment dosages and durations, and the presence of sexual dysfunction. Additionally, we aimed to evaluate the prevalence of improved sexual function resulting from methylphenidate use. A systematic literature review was performed using the PubMed database in accordance with PRISMA guidelines. The initial search yielded 186 articles, of which 14 met the inclusion criteria and were analyzed. Clinical studies involving changes in libido, erectile function, ejaculation, semen quality, and sexual behavior due to methylphenidate were reviewed. The findings indicate that methylphenidate can have both negative and positive effects on sexual function. In some patients, particularly those with psychiatric comorbidities, methylphenidate was associated with decreased libido and ejaculation disorders. In other cases, especially in individuals with preexisting dysfunctions or on low doses, it appeared to enhance sexual arousal and performance. Methylphenidate may influence sexual function in complex ways depending on individual patient profiles and treatment variables. Clinicians should be aware of these potential outcomes and consider sexual health as part of the therapeutic discussion when prescribing methylphenidate.
哌甲酯是一种精神振奋剂，通过抑制突触间隙的再摄取机制来增强多巴胺和去甲肾上腺素的神经传递。研究表明，性功能障碍在精神科患者中很普遍。我们研究的目的是评估哌甲酯对患者性健康的影响，确定性功能障碍的具体类型，并分析精神疾病、治疗剂量和疗程与性功能障碍之间的相关性。此外，我们旨在评估使用哌甲酯后性功能改善的发生率。根据PRISMA指南，使用PubMed数据库进行了系统的文献综述。初步检索得到186篇文章，其中14篇符合纳入标准并进行了分析。对涉及哌甲酯引起的性欲、勃起功能、射精、精液质量和性行为变化的临床研究进行了综述。研究结果表明，哌甲酯对性功能可能有负面影响和正面影响。在一些患者中，特别是那些患有精神疾病合并症的患者，哌甲酯与性欲减退和射精障碍有关。在其他情况下，尤其是在已有性功能障碍的个体或低剂量用药的个体中，它似乎能增强性唤起和性功能表现。哌甲酯可能会以复杂的方式影响性功能，这取决于个体患者的情况和治疗变量。临床医生应该意识到这些潜在结果，并在开具哌甲酯处方时将性健康作为治疗讨论的一部分加以考虑。
