Imipramine Anorgasmia

A 32-year-old woman with a 1-month history of depression including decreased libido received imipramine increased to 150mg at bedtime over 2 weeks.

During the third week of therapy, the woman noted complete anorgasmia with normal sexual excitation and ability to remain excited. Plasma concentrations after 3 weeks of therapy were imipramine 23 ng/ml and desipramine 115 ng/ml. Clinical improvement was seen after 4 weeks of therapy and the patient became able to achieve orgasm but only after prolonged stimulation and with reduced pleasure. Concurrent cyproheptadine 4mg improved sexual function.

Orgastic function was returned to normal on substituting desipramine 200 mg/day for imipramine 200 mg/day. Steele TE. Howell EF. Journal of Clinical Psychopharmacology 6 326-327, Oct t986

0157-7271/86/1220-0007/0$01,00/0 © ADIS Press Reactions® 20 Dec 1986 7