Ginkgo Biloba: Antidepressant-Induced Sexual Dysfunction

银杏叶：抗抑郁药引起的性功能障碍

• 批准号: 6512081
• 负责人: CINDY M MESTON
• 金额: $ 26.05万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6512081
• 关键词: alternative medicine; antidepressants; blood flow measurement; clinical trials; drug adverse effect; female; ginkgo biloba; human subject; human therapy evaluation; mental disorder chemotherapy; patient oriented research; placebos; relaxation; sex behavior; smooth muscle; women's health

Virtually all antidepressant medications are associated with a high incidence of adverse sexual side effects. In women, the side effects most commonly reported include decreased sexual arousal with decreased lubrication, delayed or inhibited orgasm, and decreased sexual desire. To date, there are no effective pharmacological antidotes for treating these sexual side effects. Gingko biloba extract (GBE), a naturally occurring substance from the ancient Chinese Gingko tree, has properties proven to increase peripheral blood flow and to facilitate the relaxation of smooth muscle tissue. Its effectiveness in this regard has been demonstrated in numerous clinical trials that show gingko biloba to be highly efficient in treating peripheral vascular disorders. Female sexual arousal involves a complex interplay of these very actions - the relaxation of smooth muscle tissue and the inflow of blood to the genital region. Hence, pharmacologically, it is feasible that GBE may be effective in enhancing female sexual arousal. Moreover, given that the mechanisms hypothesized to facilitate female sexual function are operative at a peripheral rather than a central (i.e., neurotransmitter) level, it is unlikely that GBE would adversely impact the mood-alleviating therapeutic effects of antidepressant medications that are believed to be centrally mediated. Limited, uncontrolled studies lend support to this hypothesis. The purpose of the present study is to provide the first empirical examination of the effects of both acute and chronic GBE on subjective and physiological measures of sexual function in women who are experiencing clinically diagnosable hypoactive sexual desire disorder, female sexual arousal disorder, and/or inhibited female orgasm secondary to either to fluoxetine, sertraline, or paroxetine use. Women (N = 110) stabilized on antidepressant medication and free of a current Axis I disorder will be randomized to 8 weeks of daily treatment with either GBE (200 mg) or placebo. Sexual functioning will be assessed through (a) daily patient diary recordings, (b) patient-rating scales completed each week, and (c) blind independent evaluator ratings. The acute effects of GBE will also be assessed using vaginal photoplethysmograph techniques to assess genital blood flow, both prior to and following chronic GBE treatment. The findings from the present study will (a) help determine whether chronic and/or acute GBE facilitates sexual function in women with antidepressant-induced sexual dysfunction and, (b) examine whether acute GBE influences vaginal measures of sexual arousal. If effective, GBE could play a significant adjunctive role in the treatment of clinical depression and other psychological disorders commonly treated with antidepressant medications.

几乎所有抗抑郁药都与不良性副作用的高发生率有关。 在女性中，最常见的副作用包括随着润滑的减少，延迟或抑制性高潮以及性欲减少的性唤醒减少。 迄今为止，还没有有效的药理学解毒剂来治疗这些性副作用。 Gingko Biloba提取物（GBE）是一种天然存在的中国银河树的物质，其特性被证明可以增加外周血流量并促进平滑肌组织的放松。 在许多临床试验中已证明了它在这方面的有效性，这些临床试验表明，金黄色的biloba在治疗周围血管疾病方面高效。 女性性唤醒涉及这些动作的复杂相互作用 - 平滑肌组织的松弛和血液流向生殖器区域。 因此，从药理上讲，GBE可以有效增强女性性唤醒是可行的。 此外，鉴于假设促进女性性功能的机制是在外科外观而不是中心的（即神经递质）水平的工作，因此GBE不太可能对抗抑郁药对抗抑郁药物的抗抑郁药物的效果产生不利影响。 有限的，不受控制的研究为这一假设提供了支持。 本研究的目的是对急性和慢性GBE对性功能的主观和生理功能的影响进行首次实证检查，这些妇女对临床上可诊断可诊断的性疾病性性欲疾病，女性性唤醒疾病，/或抑制女性性高潮对临床上可诊断的性障碍性疾病，女性性高潮，对结合素，挥发性，言语，官僚，官僚，或帕克西汀的使用。 在抗抑郁药中稳定的女性（n = 110），没有当前轴I疾病，将随机分为GBE（200 mg）或安慰剂的每日治疗8周。 性功能将通过（a）每天的患者日记记录，（b）每周完成的患者评价量表以及（c）盲目独立评估者评级来评估性功能。 GBE的急性效应还将使用阴道光杀伤学技术评估，以评估慢性GBE治疗前后的生殖器血流。本研究的发现将（a）帮助确定慢性和/或急性GBE是否促进了抗抑郁药诱发的性功能障碍的女性的性功能以及（b）检查急性GBE是否影响性唤醒的阴道测量。如果有效，GBE可以在治疗临床抑郁症和其他通常用抗抑郁药治疗的心理疾病的治疗中发挥重要作用。