Sexual dysfunction secondary to selective serotonin re-uptake inhibitors (SSRIs) is an almost universal, yet pooly understood phenomenon. Not uncommonly, this unpleasant side effect leads to noncompliance. Since SSRIs have been so successful clinically, it is time to find a safe and effective treatment for this side effect. This paper reports on five cases in which low dosages of the psychostimulants, dextroamphetamine and methylphenidate, administered on a p.r.n. basis, reversed the sexually inhibiting side effects of the SSRIs fluxetine, setraline, and paroxetine in patients with and without attention deficit hyperactivity disorder. In addition, the women experienced enhanced levels of arousal, orgasmic sensation and excitement during the resolution phase (afterglow) of the sexual response cycle on psychostimulants, and the men noted firmer erections.
There recently has been a tremendous amount of literature concerning post-traumatic stress disorder in both the scientific and the lay literature. However, with all the interest, and all the material that has been generated, symptoms of sexual dysfunction, which may be present in a significant number of patients suffering from this disorder, have not been included in the diagnostic criteria or clinical descriptions. While working with Vietnam veterans who possessed the diagnosis of post-traumatic stress disorder during 1984 at a New York area Veteran's Administration Hospital, it became apparent that many of these men suffered from erectile difficulties. While these observations are by no means epidemiologically significant, they do suggest that the sexual status of this patient population deserves investigation.
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