Center for Brain, Biology and Behavior, University of Nebraska Lincoln, Lincoln, Nebraska.
Department of Psychology, University of Nebraska - Lincoln, Lincoln, Nebraska.
J Clin Psychiatry. 2024 Oct 21;85(4):24m15357. doi: 10.4088/JCP.24m15357.
To describe effects of gepirone extended-release (ER), an azapirone, on sexual function in patients receiving treatment for major depressive disorder (MDD). Sexual function was assessed in 1,767 patients (67% women) across five Phase 3 randomized controlled clinical trials comparing gepirone-ER against placebo or active treatment with selective serotonin reuptake inhibitors (SSRIs) for treatment of MDD. All five trials assessed sexual functioning in the short term (8 weeks), with three including long-term extensions of 16, 20, or 44 weeks. Sexual function was assessed prospectively and throughout trials via clinical interview and well-validated survey measures. Across studies, gepirone-ER was equivalent to placebo on sexual side effects and treatment-emergent sexual dysfunction. Relative to SSRIs, gepirone-ER was associated with significantly better effect on sexual function across time points studied. Evidence from patients without sexual dysfunction at baseline demonstrates superiority of gepirone-ER over SSRIs in the first few weeks of treatment, when patients are most vulnerable to the negative effects of sexual side effects on medication nonadherence/ discontinuation. Importantly, these benefits were maintained across treatment. Gepirone-ER was not associated with sexual dysfunction in patients with MDD. Rates of sexual side effects and treatment-emergent sexual dysfunction with gepirone-ER were comparable to those reported for placebo and lower than sexual side effects reported for active treatment with SSRIs.
描述氮平(azapirone) gepirone 延长释放剂(ER)对接受治疗的重度抑郁症(MDD)患者性功能的影响。 在五项比较 gepirone-ER 与安慰剂或与选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗 MDD 的活性药物治疗的 3 期随机对照临床试验中,对 1767 名患者(67%为女性)的性功能进行了评估。所有五项试验均在短期内(8 周)评估了性功能,其中三项试验包括了 16、20 或 44 周的长期扩展。通过临床访谈和经过充分验证的调查措施,前瞻性地在整个试验中评估性功能。 在研究中,gepirone-ER 在性副作用和治疗引发的性功能障碍方面与安慰剂相当。与 SSRIs 相比,gepirone-ER 在研究的各个时间点上与性功能的改善具有显著相关性。在基线时没有性功能障碍的患者的证据表明,gepirone-ER 在治疗的最初几周内优于 SSRIs,因为此时患者最容易受到性副作用对药物依从性/停药的负面影响。重要的是,这些益处在整个治疗过程中得以维持。 gepirone-ER 不会导致 MDD 患者出现性功能障碍。gepirone-ER 的性副作用和治疗引发的性功能障碍发生率与安慰剂相当,低于 SSRIs 活性药物治疗报告的性副作用发生率。