Gabapentin-Induced Ejaculatory Failure and Anorgasmia
1999; American Psychiatric Association; Volume: 156; Issue: 6 Linguagem: Inglês
10.1176/ajp.156.6.972
ISSN1535-7228
AutoresLawrence A. Labbate, Robert N. Rubey,
Tópico(s)Attention Deficit Hyperactivity Disorder
ResumoBack to table of contents Previous article Next article Letter to the EditorFull AccessGabapentin-Induced Ejaculatory Failure and AnorgasmiaLAWRENCE A. LABBATE, M.D., and ROBERT N. RUBEY, M.D., LAWRENCE A. LABBATESearch for more papers by this author, M.D., and ROBERT N. RUBEYSearch for more papers by this author, M.D., Charleston, S.C.Published Online:1 Jun 1999https://doi.org/10.1176/ajp.156.6.972AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Psychotropic drugs are well known to affect sexual functioning (1) and may contribute to patient noncompliance. The serotonin reuptake antagonist antidepressants are particularly known for their effects on orgasm (2–4). Much less is known about the adverse sexual effects of anticonvulsants, although one case report suggests that carbamazepine may cause ejaculatory failure (5). We report a case of ejaculatory failure and anorgasmia associated with gabapentin.Mr. A was a 41-year-old man with a long history of bipolar II disorder and alcohol dependence with intermittent cocaine abuse. After completing a 4-week alcohol treatment program, he developed mild hypomania. He had no medical problems and no history of sexual dysfunction. Gabapentin treatment was initiated for hypomania at 300 mg per day and gradually titrated to 600 mg 3 times per day over 1 month. While taking 300 mg of gabapentin 3 times per day, he noticed orgasm was more difficult to attain. Neither libido nor erection was affected. Gabapentin reduced his hypomania, but as the dose increased, he found ejaculation and orgasm increasingly difficult to achieve. He could have intercourse with a normal erection for 20 minutes but could not ejaculate. At times he attained a sense of incomplete orgasm sensation but did not ejaculate. There was no retrograde ejaculation. Mr. A took gabapentin for 4 months and eventually stopped the medication because of his inability to ejaculate. During this time, he remained abstinent from alcohol, and the results of three urine drug screens for cocaine and marijuana were negative. He denied using other illicit or over-the-counter drugs. One week after stopping the gabapentin dose, he reported the return of his usual orgasm and ejaculation abilities.This case demonstrates a clear on/off phenomenon of anorgasmia related to gabapentin, which may be dose related. The frequency of this adverse effect is unknown, although sexual side effects were reported as uncommon in clinical trials when epilepsy was treated. It is unknown if gabapentin might affect other areas of sexual functioning, although, in this man, it did not. The mechanism of action of gabapentin is unknown, and the effects on ejaculation or other aspects of sexual function are also unknown. As gabapentin becomes more commonly used in psychiatric practice, the frequency of this adverse effect may become more apparent.References1. Gitlin MJ: Psychotropic medications and their effects on sexual function: diagnosis, biology, and treatment approaches. J Clin Psychiatry 1994; 55:406–412Medline, Google Scholar2. Hsu JH, Shen WW: Male sexual side effects associated with antidepressants: a descriptive clinical study of 32 patients. Int J Psychiatry Med 1995; 25:191–201Crossref, Medline, Google Scholar3. Balon R, Yeragani VK, Pohl R, Rainesh C: Sexual dysfunction during antidepressant treatment. J Clin Psychiatry 1993; 54:209–212Medline, Google Scholar4. Labbate LA, Grimes JB, Hines A, Arana GW: Sexual dysfunction induced by serotonin reuptake antidepressants. J Sex Marital Ther 1998; 24:3–12Crossref, Medline, Google Scholar5. Leris AC, Stephens J, Hines JE, McNicholas TA: Carbamazepine-related ejaculatory failure. 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HUSAIN, M.D., JOHN H. MONTGOMERY, D.O., PRAVEEN FERNANDES, M.D., and LYNN MORROW, M.D., 1 July 2002 | American Journal of Psychiatry, Vol. 159, No. 7Modafinil-Associated Clozapine ToxicityJOHN R. DEQUARDO, M.D., 1 July 2002 | American Journal of Psychiatry, Vol. 159, No. 7Gabapentin-Induced Anorgasmia in WomenARTHUR C. GRANT, M.D., PH.D., and HYUNJUE OH, R.N., M.S.N., 1 July 2002 | American Journal of Psychiatry, Vol. 159, No. 7Epilepsy & Behavior, Vol. 3, No. 5Gabapentin-induced anorgasmia as a cause of noncompliance in a bipolar patient20 December 2001 | Bipolar Disorders, Vol. 3, No. 1Seizure, Vol. 10, No. 5Journal of Sex Education and Therapy, Vol. 26, No. 3Reactions Weekly, Vol. &NA;, No. 759 Volume 156Issue 6 June 1999Pages 972-972 Metrics History Published online 1 June 1999 Published in print 1 June 1999
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