When pharmacotherapy for delayed ejaculation is being considered, eliminating iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, antipsychotics), is important. In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than SSRIs (eg, citalopram) do.
Adjunctive therapies should be considered. Alpha sympathomimetics have been used successfully in patients with retrograde ejaculation. Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder.
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Cite this: Bradley Schwartz, Michel E. Rivlin. Fast Five Quiz: Sexual Dysfunction - Medscape - Aug 12, 2019.