Walker P W, Cole J O, Gardner E A, Hughes A R, Johnston J A, Batey S R, Lineberry C G
Department of Psychiatry, University of Tennessee, Memphis.
J Clin Psychiatry. 1993 Dec;54(12):459-65.
This study was conducted to determine the effect of bupropion on the sexual functioning of male and female outpatients who developed anorgasmia or delayed orgasm while receiving fluoxetine treatment for depression.
Thirty-nine patients who satisfied criteria for participation in the study discontinued fluoxetine treatment and entered a 2-week washout phase followed by an open 8-week bupropion treatment phase. Three parameters of sexual functioning were followed throughout the study: orgasm function, libido, and satisfaction with overall sexual functioning. Depression was also evaluated at each visit.
All patients reported orgasm delay and/or failure at the time of fluoxetine discontinuation. Orgasm function, libido, and satisfaction with sexual functioning improved during the 2-week fluoxetine washout period and during the bupropion treatment phase. Ninety-four percent of patients (29/31) had complete or partial resolution of their orgasm dysfunction at the end of bupropion treatment, and 81% of patients (25/31) were "much" or "very much" more satisfied with their overall sexual functioning. Most patients entered the study with decreased libido on fluoxetine. Libido was "much" or "very much" increased for 81% of patients (25/31) at the end of the study. In addition, depression scores on the Hamilton Rating Scale for Depression and Clinical Global Impressions-Severity scale significantly improved during the bupropion treatment phase. Finally, bupropion was well tolerated by most patients.
Bupropion may be an appropriate antidepressant for patients who develop sexual dysfunction during fluoxetine treatment or for whom sexual dysfunction is a concern.
本研究旨在确定安非他酮对在接受氟西汀治疗抑郁症期间出现性高潮缺失或性高潮延迟的男性和女性门诊患者性功能的影响。
39名符合研究参与标准的患者停止氟西汀治疗，进入为期2周的洗脱期，随后是为期8周的安非他酮开放治疗期。在整个研究过程中跟踪性功能的三个参数：性高潮功能、性欲和对整体性功能的满意度。每次就诊时也评估抑郁情况。
所有患者在停用氟西汀时均报告有性高潮延迟和/或缺失。在氟西汀2周洗脱期和安非他酮治疗期，性高潮功能、性欲和对性功能的满意度均有所改善。94%的患者（29/31）在安非他酮治疗结束时性高潮功能障碍完全或部分缓解，81%的患者（25/31）对其整体性功能“非常”或“极其”满意。大多数患者在开始研究时服用氟西汀后性欲降低。在研究结束时，81%的患者（25/31）性欲“非常”或“极其”增强。此外，在安非他酮治疗期，汉密尔顿抑郁评定量表和临床总体印象严重程度量表的抑郁评分显著改善。最后，大多数患者对安非他酮耐受性良好。
对于在氟西汀治疗期间出现性功能障碍或担心性功能障碍的患者，安非他酮可能是一种合适的抗抑郁药。
