SSRI抗抑郁剂对射精的影响:一项双盲,随机,安慰剂对照研究与氟西汀、氟伏沙明、帕罗西汀、舍曲林。

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医学博士Waldinger Hengeveld兆瓦,Zwinderman啊,奥利维尔•B

SSRI抗抑郁剂对射精的影响:一项双盲,随机,安慰剂对照研究与氟西汀、氟伏沙明、帕罗西汀、舍曲林。

中国Psychopharmacol。1998年8月,18 (4):274 - 81。

PubMed ID
9690692 (在PubMed
]
文摘

抑郁症是一种常见的性功能障碍的原因,但也抗抑郁药物通常与性有关的副作用。本文包含两个相关的研究。第一个双盲,安慰剂对照研究男性终生快速射精,旨在评估假定的差异主要选择性5 -羟色胺再摄取抑制剂(SSRIs)(氟西汀、氟伏沙明、帕罗西汀、舍曲林)关于他们ejaculation-delaying效果。一次通过阴道射精延迟时间60人(IELT) 1分钟或更少被随机分配接受氟西汀20毫克/天,氟伏沙明100毫克/天,帕罗西汀20毫克/天,舍曲林50毫克/天,6周或安慰剂。在为期6个月的月基线和治疗周期中,男人在家里用秒表测量他们的IELT。试验完成后由51人。在六周的治疗期间,安慰剂组的几何平均IELT常数约20秒。方差分析显示组间差异的进化IELT延迟(p = 0.0004);在帕罗西汀、氟西汀和舍曲林组有一个逐渐增加到大约110秒,而在氟伏沙明集团IELT只是增加到大约40秒。帕罗西汀、氟西汀和舍曲林组差异显著(p < 0.001, p < 0.001, p = 0.017,分别)从安慰剂,但氟伏沙明组(p = 0.38)。 Compared with baseline, paroxetine exerted the strongest delay in ejaculation, followed by fluoxetine and sertraline. There was no clinically relevant delay in ejaculation with fluvoxamine. In men with lifelong rapid ejaculation, paroxetine delayed ejaculation most strongly, whereas fluvoxamine delayed ejaculation the least. The second double-blind, placebo-controlled study was carried out in men with lifelong rapid ejaculation (IELT < or = 1 minute) and in men with lifelong less-rapid ejaculation (IELT > 1 minute) to investigate whether data about SSRI-induced delayed ejaculation in men with rapid ejaculation may be extrapolated to men with less-rapid ejaculation. After measurement of IELT at home (using a stopwatch) during a 1-month baseline assessment, 32 men with an IELT of 1 minute or less (group 1) or more than 1 minute (group 2) were randomly assigned to receive paroxetine 20 mg/day or placebo for 6 weeks in a double-blind manner. Patients continued to measure their IELTs at home during the 6 weeks of the study. At baseline, 24 patients consistently had IELTs of one minute or less (group 1), and eight patients had IELTs of more than 1 minute (group 2). The geometric mean IELT was 14 seconds in group 1 and 83 seconds in group 2. Twelve patients in group 1 and five in group 2 were randomized to the paroxetine 20 mg/day. The percentage increase in the geometric mean IELT compared with baseline in patients treated with paroxetine was 420% (95% confidence interval [CI], 216-758%) in group 1 and 480% (95% CI, 177-1,118%) in group 2 (p = 0.81). After 6 weeks of treatment with paroxetine, the geometric mean IELT was 92 seconds in group 1 and 602 seconds in group 2 (p < 0.001). Therefore, the paroxetine-induced percentage increase in IELT seems to be independent of the baseline IELT. This suggests that ejaculation-delaying side effects of some SSRIs investigated in men with lifelong rapid ejaculation may be generalized to men with less-rapid ejaculation.

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