曲唑酮对帕罗西汀所致性功能障碍的作用观察

Effects of trazodone on sexual dysfunction caused by paroxetine

目的:探讨曲唑酮对帕罗西汀所致性功能障碍的作用。方法:选取服用帕罗西汀后出现性功能障碍者共53例,入組后合并曲唑酮治疗,1周内渐加至100mg^200mg/d,观察4周。分别于入组时、2周末、4周末进行汉密尔顿抑郁量表HAMD-17、性健康量表(SHS)、勃起障碍评定量表(EDRS)、治疗时副反应量表(TESS),分别评定抑郁程度、性生活满意度、勃起功能及不良反应。结果:干预2、4周末,HAMD评分与入组时比较虽有所降低,差异无统计学意义(P>0.05);EDRS评分2周末与入组时比较差异有统计学意义(P<0.05),说明曲唑酮对帕罗西汀所致的勃起障碍有明显的改善作用;至4周末这一趋势更为明显,差异有统计学意义(P<0.01);干预2、4周末,SHS评分与入组时比较显示了与EDRS类似结果;不同的是4周末SHS评分与2周末比较差异明显(P<0.05)。结论:曲唑酮对帕罗西汀所致的性功能障碍有明显的改善作用,值得在今后临床中推广应用。

Objectives： To explore the effects of trazodone on sexual dysfunction caused by paroxetine. Methods： 53 patients with sexual dysfunction caused by paroxetine were selected and all treated with trazodone as well as paroxetine. The dose of trazodone was gradually increased to 100mg- 200mg/d in a week, and kept observation for 4 weeks. Hamilton Depression Scale （HAMD - 17 ）, Sexual health Scale （SHS）, Erectile Dysfunction Rating Scale （EDRS） and Treatment Emergent Symptom Scale （TESS） were used to assess depressive degree, sex- ual satisfaction, erectile dysfunction and adverse reactions respectively at the time of enrollment, end of 2 weeks and 4 weeks. Results： Compared with the baseline, the score of HAMD decreased after 2 and 4 weeks＇ intervention, but the difference was not statistically significant （P 〉 0.05）. The EDRS score on the end of 2 weeks was significandy different compared with the baseline （ P 〈 0.05 ）, which showed that there was obvious improvement of trazodone in the treatment of erectile dysfunction induced by paroxetine. This trend was more obvious at the end of 4 weeks, with statistically significant difference （P 〈 0.01 ） ; after 2 weeks＇ and 4 weeks＇ intervention, the score of SHS compared with the baseline showed similar results with the EDRS. The difference in the score of SHS at the end of 4 weeks was significant compared with that at the end of 2 weeks （ P 〈 0.05 ）. Conclusions： Trazodone can significantly improve sexual dysfunction caused by paroxetine, which is worthy of clinical popularization and application in the future.