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題 名 | 早發性射精的藥物與治療=Treatment and Management of Premature Ejaculation in Adults |
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作 者 | 許博淳; 李浩銓; | 書刊名 | 藥學雜誌 |
卷 期 | 31:1=122 2015.03[民104.03] |
頁 次 | 頁86-90 |
分類號 | 418.21 |
關鍵詞 | 早發性射精; 早洩; Dapoxetine; SSRI off label use; PE; Premature ejaculation; |
語 文 | 中文(Chinese) |
中文摘要 | 俗稱早洩的早發性射精是一種常見且令人困擾的男性性功能障礙,成因可能是因 為陰莖過度敏感、中樞神經傳導異常或是心理緊張所造成,但確切的致病機轉目前 仍不清楚。目前建議的治療方法為合併心理與藥物治療;心理治療方面主要為建立 病人的自信心、降低情緒的過度緊張。希望在治療後能使病人與伴侶雙方能夠互相信 任與了解,去除因心理因素引發的早發性射精。藥物治療方面,傳統上建議第一線用 藥為 SSRI 類藥品,例如 fluoxetine 或 paroxetine,需要服用至少數周後治療效果才會 顯現,但停藥後會失效且長期服用可能會導致其他副作用。其他種類的藥物也許對 於 早發性射精有幫助,但效果存疑。Dapoxetine 是新一代治療早發性射精的 SSRI 類 藥品,其特點為不需持續服用,僅需要時使用即可。且因代謝較快,副作用較傳統 SSRI 類藥品少,但仍需注意相關藥物的交互作用。雖然在研究上證實藥物可以有效 延緩射精時間,但對患者來說,時間並非評量性生活是否成功的唯一標準,必須額外 考量病人的心理影響及生活品質是否改善。 |
英文摘要 | Premature ejaculation is a common, bothering male sexual disorder. It may be caused by penile hypersensitivity, the abnormality of cerebral neurotransmission, or the psychological panic. But the precise mechanism is still unclear. The recommend therapies of PE are combining medicine, psychological and educational training. The training is major to rebuild the patient's self-confidence and relieve the patient's feelings of annoyance and nervous. The aim of the training is that patient and partner can trust each other and recognize where the problem is. The goal is to solve premature ejaculation result from psychological factor. Firstline choice of medicine is SSRIs, such as fluoxetine or paroxetine. The delayed ejaculation effects of SSRIs will appear after long-term daily dosing regimens about several weeks, but it may lose effectiveness after medicine discontinued. The adverse effects of SSRIs may worsen the sexual ability of patient. Other therapeutic options may be helpful, but the effects are still doubtful. Dapoxetine is the first, and only medicine that approved for PE treatment. It's taken as-needed, and has less side effect because of rapid metabolization. But we still need to pay attention on the drug-drug interaction between dapoxetine and others, especially other SSRIs or MAOIs. Although medicine may delay the time of ejaculation, time is not the absolute principle to determine someone's sexual life. On the other hand, the points we have to assess are psychological factors and interpersonal relationships, and after training and medication, does patient have a better quality of life or not. |
本系統中英文摘要資訊取自各篇刊載內容。