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首页> 外文期刊>The journal of clinical psychiatry >Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine.
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Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine.

机译：用莫氯倍特，帕罗西汀，舍曲林和文拉法辛治疗期间抗抑郁药诱发的性功能障碍。

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BACKGROUND: Recent reports suggest that adverse effects on sexual function occur in up to 50% of patients who are treated with selective serotonin reuptake inhibitor (SSRI) antidepressants. Previously cited low rates were more likely a function of underreporting than underoccurrence. There is less evidence about rates of dysfunction with serotonin-norepinephrine reuptake inhibitor (SNRI) and reversible inhibitor of monoamine oxidase A (RIMA) antidepressants. The purpose of this report is to evaluate disturbances in sexual drive/desire and arousal/orgasm in 107 patients who met criteria for major depressive disorder and received treatment with either moclobemide, paroxetine, sertraline, or venlafaxine. METHOD: All consenting eligible patients who met DSM-IV criteria for major depressive disorder completed the Sexual Functioning Questionnaire, version 1 (SFQ) and were assessed using the 17-item Hamilton Rating Scale for Depression (HAM-D) prior to and after 8 or 14 weeks of antidepressant therapy. Analyses were carried out to examine the effect of gender, drug type, pretreatment level of sexual dysfunction, and drug response on reported sexual dysfunction. RESULTS: Compared with women, men experienced a significantly greater level of drug-related impairment in drive/desire (p < .05), whereas there were no statistically significant differences in levels of arousal/orgasm impairment between men and women. The reported impairment in drive/desire items for men ranged from 38% to 50% and from 26% to 32% for women. No differences were found across the 4 antidepressants in men, whereas in women, rates of dysfunction were generally higher with sertraline and paroxetine, but only significantly so in comparison with moclobemide on some measures (p < .03). Rates of sexual dysfunction with venlafaxine tended to fall between those of SSRIs and the RIMA agent. An unexpected relationship was found between favorable drug response and a decreased level of drug-induced sexual dysfunction. CONCLUSION: Antidepressant-induced sexual dysfunction occurs in approximately 30% to 70% of patients who are treated with sertraline or paroxetine. Lower rates are reported with moclobemide and venlafaxine. Clinicians should evaluate the various aspects of sexual dysfunction before and during antidepressant therapy.
机译：背景：最近的报道表明，接受选择性5-羟色胺再摄取抑制剂（SSRI）抗抑郁药治疗的患者中，多达50％对性功能产生不良影响。先前引用的低比率更可能是漏报而不是漏报。关于5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）和单胺氧化酶A（RIMA）抗抑郁药的可逆抑制剂的功能障碍发生率的证据较少。本报告的目的是评估107名符合重度抑郁症标准并接受莫氯贝胺，帕罗西汀，舍曲林或文拉法辛治疗的患者的性欲/性欲和唤醒/性高潮障碍。方法：所有符合DSM-IV标准的重度抑郁症患者的合格患者均完成了第1版性功能调查问卷（SFQ），并在8之前和之后使用17项汉密尔顿抑郁量表（HAM-D）进行了评估。或14周的抗抑郁治疗。进行了分析以检查性别，药物类型，性功能障碍的预处理水平以及药物反应对报告的性功能障碍的影响。结果：与女性相比，男性在驾驶/欲望方面经历了与药物相关的明显损伤（p <.05），而男性与女性之间的觉醒/性高潮损伤水平无统计学差异。据报告，男性在驾驶/欲望方面的损伤范围为38％至50％，女性为26％至32％。在男性中，这四种抗抑郁药之间没有差异，而在女性中，舍曲林和帕罗西汀的功能障碍率通常更高，但在某些方面与莫氯贝米相比则只有显着差异（p <.03）。文拉法辛的性功能障碍发生率倾向于介于SSRI和RIMA剂之间。在良好的药物反应与药物引起的性功能障碍水平降低之间发现了出乎意料的关系。结论：抗抑郁药引起的性功能障碍约有30％至70％的患者接受舍曲林或帕罗西汀治疗。据报道莫洛贝比德和文拉法辛的使用率较低。临床医生应在抗抑郁治疗之前和期间评估性功能障碍的各个方面。

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