Shen W W, Hsu J H
Saint Louis University School of Medicine, Missouri, USA.
Int J Psychiatry Med. 1995;25(3):239-48. doi: 10.2190/N6C0-DWX2-G4EA-7688.
After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects.
In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects.
Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described.
With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.
1988年选择性5-羟色胺再摄取抑制剂在美国市场出现后，美国精神科医生在治疗抑郁症时面对更多的抗抑郁药选择。选择性5-羟色胺再摄取抑制剂的处方越来越普遍，因为它们易于由医生滴定剂量且患者耐受性良好。然而，使用选择性5-羟色胺再摄取抑制剂常与女性性功能障碍相关。本研究的目的是描述这些与选择性5-羟色胺再摄取抑制剂相关的女性性副作用。
在一项回顾性系列研究中，对110名接受选择性5-羟色胺再摄取抑制剂治疗的女性门诊患者的临床记录进行审查，以了解性欲丧失或减退、性高潮障碍（性高潮缺失或性高潮延迟）以及缓解性副作用的临床管理模式。
确定了21例接受氟西汀治疗、9例接受帕罗西汀治疗和5例接受舍曲林治疗的女性性抑制病例。描述了与选择性5-羟色胺再摄取抑制剂相关的性不良反应的转归以及恢复这些副作用的临床管理情况。
尽管在解释数据方面存在一些局限性，但本研究结果表明，与选择性5-羟色胺再摄取抑制剂相关的女性性功能障碍发生率高于我们之前的认知，三种选择性5-羟色胺再摄取抑制剂引发女性性副作用的可能性相同，安非他酮不存在或很少引发女性性不良反应，并且这些副作用可通过等待自然缓解、减少选择性5-羟色胺再摄取抑制剂剂量、换用安非他酮及其他抗抑郁药或使用解毒剂来处理。
