摘要
性是人类一种重要的个性表现形式,几十年来,性功能一直是精神分裂症患者中一个被忽视的领域,精神分裂症患者可能是无性的,这可能是妄想、幻觉、敌意和阴性症状等压倒一切情况的次要因素。性功能的缺乏是由于先天因素,即阴性症状(冷漠、嗜好和失代偿),也是前额叶功能障碍的结果,即不能计划和执行有意义的关系。精神药物的不良反应,特别是典型的抗精神病药物,如肌张力障碍、过度镇静和高催乳素血症可能会干扰患者的性活动。本文综述了精神分裂症的神经生物学在了解性功能的背景下,结合多巴胺-5-羟色胺神经递质相互作用的知识和受体的靶向性。干预方法包括精神药理学和心理社会干预。从性的角度来看,我们建议将非典型抗精神病药作为治疗药物天真患者和已经接受精神药理学药物的患者的一线治疗,以考虑从典型的药物转向非典型的抗精神病药物。阿立哌唑、氯氮平、奥氮平和奎硫平因其非典型作用机制而对性功能恢复有好处。阿立哌唑、氯氮平、奥氮平和奎硫平因其非典型的作用机制而对性功能恢复有好处。然而,代谢综合征等潜在的不良反应加以适当处理,以防止负面后果。心理社会干预,即心理教育、脱脂治疗、支持性心理治疗和精神康复也在管理中起着至关重要的作用。总之,通过这些生物社会干预,恢复性功能是精神分裂症患者可以达到的恢复目标。
关键词: 非典型抗精神病药,性,康复,精神分裂症,心理教育,心理治疗。
Current Drug Targets
Title:The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia
Volume: 19 Issue: 12
关键词: 非典型抗精神病药,性,康复,精神分裂症,心理教育,心理治疗。
摘要: Sexuality is an important dimension in human beings as a form of expression of individuality. For many decades, sexual functioning has been a neglected area among patients suffering from schizophrenia. It was a presumption that patients with schizophrenia could be asexual and this could be secondary to overwhelming situations of delusion, hallucination, hostility and negative symptoms among others. The deficient in sexual functioning are due to innate factors, i.e. negative symptoms (apathy, avolition and amotivation) and also as a result of prefrontal dysfunction, i.e. inability to plan and execute meaningful relationship. Adverse effects of the psychopharmacological agents, especially the typical antipsychotics, e.g. dystonia, excessive sedation and hyperprolactinemia may interfere with patients’ sexual activity. In this review, we highlight the neurobiology of schizophrenia in the context of understanding sexual functioning and to integrate the knowledge of dopamine-serotonin neurotransmitter's interaction and the receptors’ target. Interventional approaches consist of psychopharmacological and psychosocial interventions. In the perspective of sexuality, we recommend atypical antipsychotic should be placed as the first line treatment for both drug naïve patients and also to patients who are already receiving psychopharmacological agents in consideration for a drug-switch from typical to atypical antipsychotics. Aripiprazole, clozapine, olanzapine and quetiapine exert benefits in terms of sexual functioning recovery due to their atypical mechanism of action. However, the potential adverse effect like metabolic syndrome should be adequately managed to prevent negative consequences. Psychosocial interventions, i.e. psychoeducation, destigmatization, supportive psychotherapy and psychiatric rehabilitation also play a crucial role in the management. In conclusion, restoration of sexual function is an achievable recovery target in patients with schizophrenia through these biopsycho- social interventions.
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The Role of Atypical Antipsychotics in Sexuality: Road to Recovery in Schizophrenia, Current Drug Targets 2018; 19 (12) . https://dx.doi.org/10.2174/1389450118666170502130126
DOI https://dx.doi.org/10.2174/1389450118666170502130126 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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