估计血清素能抗抑郁药导致的不可逆ssri后性功能障碍(PSSD)的风险。

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-04-21 DOI:10.1186/s12991-023-00447-0
Joseph Ben-Sheetrit, Yehonathan Hermon, Shlomo Birkenfeld, Yehiel Gutman, Antonei B Csoka, Paz Toren
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引用次数: 2

摘要

背景:性功能障碍是5 -羟色胺能抗抑郁药(SA)治疗的常见副作用,并且在一些患者中持续存在,这种情况称为ssri后性功能障碍(PSSD)。PSSD的风险是未知的,但被认为是罕见的,难以评估。本研究旨在评估SAs治疗男性勃起功能障碍(ED)和PSSD的风险。方法:使用以色列最大的HMO计算机数据库进行19年回顾性队列分析。用磷酸二酯酶-5抑制剂处方定义ED。12,302名年龄在21-49岁的男性符合以下标准:不吸烟,无医学或精神合并症或与ED相关的药物,无酒精或物质使用。使用Logistic回归来估计sa治疗组与非sa治疗组的ED风险,评估有无年龄、体重指数(BMI)、社会经济地位(SES)、抑郁和焦虑的影响,得出粗比值比和调整比值比(分别为cOR和aOR)。结果:sa与ED风险增加相关(cOR = 3.6, p)。结论:这项工作首次评估了与最常用的抗抑郁药物相关的不可逆ED的小但重要的风险,这应该加强获得充分的治疗知情同意的过程。
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Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants.

Background: Sexual dysfunction is a common side effect of Serotonergic antidepressants (SA) treatment, and persists in some patients despite drug discontinuation, a condition termed post-SSRI sexual dysfunction (PSSD). The risk for PSSD is unknown but is thought to be rare and difficult to assess. This study aims to estimate the risk of erectile dysfunction (ED) and PSSD in males treated with SAs.

Methods: A 19-year retrospective cohort analysis was conducted using a computerized database of the largest HMO in Israel. ED was defined by phosphodiesterase-5 inhibitors prescriptions. 12,302 males aged 21-49 met the following criteria: non-smokers, no medical or psychiatric comorbidities or medications associated with ED, no alcohol or substance use. Logistic regression was used for estimation of ED risk in SA-treated subjects compared to non-SA-treated controls, assessed with and without the effects of age, body mass index (BMI), socioeconomic status (SES), depression and anxiety, yielding crude and adjusted odds ratios (cOR and aOR, respectively).

Results: SAs were associated with an increased risk for ED (cOR = 3.6, p < 0.000001, 95% CI  2.8-4.8), which remained significant after adjusting for age, SES, BMI, depression and anxiety (aOR = 3.2, p < 0.000001, 95% CI  2.3-4.4). The risk for PSSD was 1 in 216 patients (0.46%) treated with SAs. The prevalence of PSSD was 4.3 per 100,000.

Conclusions: This work offers a first assessment of the small but significant risk of irreversible ED associated with the most commonly prescribed class of antidepressants which should enhance the process of receiving adequate informed consent for therapy.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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