摘要
选择性5-羟色胺再摄取抑制剂(SSRIs)常见于女性性功能障碍服用。女性性功能的复杂性是通过调节神经心理生理因素、人际关系问题、精神疾病和生理障碍等相互作用因素反映出来的。SSRIS引起的FSD的发生率很难估计,因为SSRIS的潜在混淆效应、多药、婚姻效应、社会文化因素以及大多数研究中的设计和评估问题。FSD诱导的SSRIs的确切机制尚不清楚,虽然SSRIs如一氧化氮(NO)、去甲肾上腺素(Noradrenergic)和多巴胺(DA)等可能调节其他神经递质系统,但目前有关SSRIs引起FSD的潜在机制的证据还不清楚,包括性欲低(性欲低)、觉醒困难(缺乏润滑)和性欲不足。FSD与SSRI的特异性关联尚未被证实。这种关系是剂量依赖性的,在5-羟色胺和多巴胺再摄取的机制、垂体催乳素释放的诱导、抗胆碱能副作用、抑制NO合成和情感记忆回路加密性体验等方面存在差异。治疗SSRI所致的FSD有多种干预策略,包括耐受性、滴定剂量、替代另一种抗抑郁药物和心理治疗。需要更好地理解SSRI诱导的FSD,以获得更好的治疗效果。
关键词: 抗抑郁药,女性性功能障碍,精神障碍,5-羟色胺选择性再摄取抑制剂,5-羟色胺受体,多巴胺再摄取。
Current Drug Targets
Title:Serotonin Selective Reuptake Inhibitors (SSRIs) and Female Sexual Dysfunction (FSD): Hypothesis on its Association and Options of Treatment
Volume: 19 Issue: 12
关键词: 抗抑郁药,女性性功能障碍,精神障碍,5-羟色胺选择性再摄取抑制剂,5-羟色胺受体,多巴胺再摄取。
摘要: Sexual dysfunctions are commonly seen in women on selective serotonin reuptake inhibitors (SSRIs). The complexities of female sexual functioning are reflected through modulation of inter- playing factors like the neuropsychophysiological factors, inter-personal and relationship issue, psychiatric co-morbidities and physical disorder. The incidence of SSRIs-induced FSD is difficult to estimate because of the potential confounding effects of SSRIs, presence of polypharmacy, marital effect, socio-cultural factors and due to the design and assessment problems in majority of the studies. The exact mechanism of FSD-induced SSRIs is unknown. It has been postulated that although SSRIs may modulate other neurotransmitter system such as nitric oxide (NO), noradrenergic and dopamine in inducing FSD. In the present review, we highlight current evidence regarding potential mechanism of SSRIs in causing FSD, which include low sexual desire (low libido), arousal difficulties (lack of lubrication), and anorgasmia. The specific association of FSD to SSRI use, has not been ellucidated. The relationship is dose-dependent, and may vary among the groups with respect to mechanism of serotonin and dopamine reuptake, induction of release of prolactin from the pituitary gland, anticholinergic side-effects, inhibition of NO synthesis and emotional-memory circuit encryption for sexual experiences. Various interventional strategies exist regarding the treatment of SSRI-induced FSD and this includes tolerance, titration dosage, substitution to another antidepressant drug and psychotherapy. There is a need of better understanding of SSRIs-induced FSD for better treatment outcome.
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Serotonin Selective Reuptake Inhibitors (SSRIs) and Female Sexual Dysfunction (FSD): Hypothesis on its Association and Options of Treatment, Current Drug Targets 2018; 19 (12) . https://dx.doi.org/10.2174/1389450117666161227142947
DOI https://dx.doi.org/10.2174/1389450117666161227142947 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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