Efficacy of testosterone combined with a PDE5 inhibitor and testosterone combined with a serotonin (1A) receptor agonist in women with SSRI-induced sexual dysfunction. A preliminary study

作者：van Rooij Kim^*; Poels Saskia; Worst Petra; Bloemers Jos; Koppeschaar Hans; Goldstein Andrew; Olivier Berend; Tuiten Adriaan

来源：European Journal of Pharmacology, 2015, 753: 246-251.

DOI：10.1016/j.ejphar.2014.10.061

• SSRI-induced sexual dysfunction
• Sublingual testosterone
• Phosphodiesterase type 5 inhibitors
• Serotonin
• Serotonin 1A receptor agonist
• CAC repeat length

Selective serotonin rcuptake inhibitors (SSRls) are known to cause sexual dysfunction, such as decreased sexual motivation, desire, arousal, and orgasm difficulties. These SSRI-induced sexual complaints have a high prevalence rate, while there is no approved pharmacological treatment for SSRI-induced sexual dysfunction It is hypothesized that a polymorphisrns in the androgen receptor gene, encoded by the nucleotides cysteine, adenine, and guanine (CAG), influence the effect of testosterone on sexual functioning. In an explorative, randomized, double-blind, placebo controlled, crossover study we investigated the possible effects of sublingual testosterone combined with a seroLonin (5-HT)(1A) receptor agonist, and of sublingual testosterone combined with a phosphodiesterase type 5 inhibitor (PDE5-i) on sexual functioning in women with SSRI-induced sexual dysfunction. Furthermore, we did an exploratory analysis to assess if the CAG polymorphism influences this effect. 21 pre- and postmenopausal women with SSRI-induced sexual dysfunction participated and underwent the following interventions: a combination of testosterone (0.5 mg) sublingually and the PDE5-i sildenafil (50 mg) and a combination of testosterone (0.5 mg) sublingually and the 5-HTiA receptor agonist buspirone (10 mg). The results show that women who use a low dose of SSRI and have relatively long CAG repeats report a marked improvement in sexual function in response to both treatments compared to placebo. This explorative study and preliminary results indicate that in women with SSRI-inducecl sexual dysfunction, a combination of testosterone sublingually and a PDE5-i or testosterone sublingually and a 5-HT1A receptor agonist might be promising treatments for certain subgroups of women with this condition.

• 出版日期2015-4-15