Desipramine First report of anhedonic ejaculation: 2 cases *

Patient 1: A 36-year-old man with dysthymia and adult attention deficit disorder controlled with low dose dexamphetamine began a trial of desipramine 25 mg/day. No other medications were taken during desipramine therapy. Therapy was discontinued after 1 week because of worsening anxiety. During desipramine therapy the patient had experienced 'ejaculation without feeling' on 2 occasions without changes in libido, erectile dysfunction or changes in the ejaculate and there were no signs or symptoms of retrograde ejaculation.

Patient 2. A 45-year-old man received desipramine 25mg increased to 150mg for dysthymia with chroniC fatigue and depressed mood. No additional medications were taken during desipramine therapy. Desipramine was discontinued after 3 weeks. The patient had experienced ·ejaculation without orgasm' while receiving desipramine therapy without changes in libido, erectile dysfunction or other difficulties. Normal function resumed 7-10 days after desipramine withdrawal.

Patient 1 declined subsequent trials but Patient 2 received nortnptyline, doxepin and phenelzine without recurrence. Dysfunctional ejaculation of this nature has not previously been reported in association with desipramine Rosenbaum JF Pollack MH Journal of PsyChiatry

1n Med1c1ne 18 85·88. No 1 1988 ''"

0757-7271/88/0730-0005/0$01.00/0 © ADIS Press REACTIONS"' 30 July 1988 5