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抗抑郁药物对性功能影响的临床意义。

Clinical implications of antidepressant drug effects on sexual function.

作者信息

Harvey K V, Balon R

机构信息

Department of Psychiatry, Wayne State University School of Medicine, Detroit, Michigan, USA.

出版信息

Ann Clin Psychiatry. 1995 Dec;7(4):189-201. doi: 10.3109/10401239509149625.

Abstract

Sexual dysfunction in a patient being treated with antidepressant medications may be due to the underlying depression, a coexisting medical illness, disruption of interpersonal relationships, or it may be a side effect of the medication. Almost all antidepressants are associated with sexual side effects that go above and beyond any symptoms that can be explained by the disease process itself. The incidence of such sexual side effects can be as high as 92% for some antidepressants. Some of the newer antidepressants currently on the market seem to have a lower incidence of sexual dysfunction as a side effect. In view of the fairly common occurrence of these unwanted effects, and their potential contribution to noncompliance, careful selection of antidepressant medications is necessary. A variety of treatment options is available, including decreasing the dosage of medication to the lowest-effective level, adjunctive medications (such as cyproheptadine, bethanechol, yohimbine, and amantadine, as well as other antidepressants) to counteract the adverse sexual effects, or switching to another antidepressant. The treatment of antidepressant-induced sexual dysfunction requires a creative approach on the part of the treating psychiatrist, and must be individualized to the patient.

摘要

正在接受抗抑郁药物治疗的患者出现性功能障碍,可能是由于潜在的抑郁症、并存的躯体疾病、人际关系的破坏,也可能是药物的副作用。几乎所有抗抑郁药都伴有超出疾病本身所能解释的任何症状的性副作用。某些抗抑郁药的此类性副作用发生率可高达92%。目前市场上一些较新的抗抑郁药似乎作为副作用的性功能障碍发生率较低。鉴于这些不良影响相当常见,且它们可能导致患者不依从治疗,因此必须谨慎选择抗抑郁药物。有多种治疗选择,包括将药物剂量减至最低有效水平、使用辅助药物(如赛庚啶、氨甲酰甲胆碱、育亨宾和金刚烷胺,以及其他抗抑郁药)来对抗不良性副作用,或换用另一种抗抑郁药。治疗抗抑郁药引起的性功能障碍需要治疗精神科医生采取创造性的方法,并且必须针对患者进行个体化治疗。

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