托吡酯致男性性功能障碍2例  

Topiramate-induced male sexual dysfunction: a report of two cases

作　　者：刘津毓 陈晓倩 王文杰[1,2] 李春华 倪健强[1] 薛群[1] 徐敏[1] 方琪[1] 胡小伟[1,2] Liu Jinyu;Chen Xiaoqian;Wang Wenjie;Li Chunhua;Ni Jianqiang;Xue Qun;Xu Min;Fang Qi;Hu Xiaowei(Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China;The First Clinical Medical School, Medical College of Soochow University, Suzhou 215006, China;Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院神经内科,215006 [2]苏州大学医学部第一临床学院,215006 [3]苏州大学附属第一医院药剂科,215006

出　　处：《药物不良反应杂志》2019年第1期72-74,共3页Adverse Drug Reactions Journal

摘　　要：2例男性患者(例1,30岁;例2,54岁)分别因症状性癫痫和偏头痛服用托吡酯治疗。例1托吡酯剂量第1、2周分别为50和75mg/d,第3周起为100mg/d。用药6个月后复诊,患者诉用药后癫痫未再发作,但用药2周后出现记忆力减退、性欲减退和早泄,未中断用药,症状持续存在。国际勃起功能指数(IIEF)评分结果显示,IIEF-1评分为19分,IIEF-5评分为16分,诊断为性功能障碍。给予左乙拉西坦抗癫痫治疗,托吡酯逐渐减量在1个月内停用。托吡酯减量2周后患者性功能障碍症状好转;停药后1个月症状消失,IIEF-1评分为28分。例2托吡酯剂量为50mg/d,服药2周后出现性欲减退和勃起困难,IIEF-1评分为23分。因该药治疗头痛有效,患者在头痛发作时间断服用,性欲减退和勃起困难症状持续存在。Two male patients (patient 1, 30 years old;patient 2, 54 years old) were treated with topiramate for symptomatic epilepsy and migraine, respectively. The dosage of topiramate in patient 1 was 50 mg/d and 75 mg/d in the first and second weeks, respectively, and 100 mg/d since the third week. Six months after topiramate treatment, the patient told the doctor that his epilepsy did not recur, but he developed hypomnesia, decreased libido, and premature ejaculation when topiramate was taken for 2 weeks. He did not stop topiramate despite that his symptoms persisted. The International Index of Erectile Function (IIEF) score showed that IIEF-1 score was 19 and IIEF-5 score was 16. He was diagnosed as sexual dysfunction. Levetiracetam was given for epilepsy, and topiramate was gradually reduced and finally discontinued within one month. The patient's sexual dysfunction improved after 2 weeks of topiramate reduction, disappeared after one month of drug withdrawal, and the IIEF-1 score was 28. The patient 2 took topiramate at a dose of 50 mg/d. After 2 weeks of topiramate treatment, the patient developed decreased libido and erectile dysfunction. The IIEF-1 score was 23. Because the drug was effective in treating his headache, the patient took topiramate intermittently during headache attacks. The patient's anaphrodisia and erectile dysfunction persisted.

关 键 词：托吡酯 抗惊厥药 早泄 勃起功能障碍 

分 类 号：R971[医药卫生—药品]