Fluoxetine and Sexual Dysfunction

This is the authors' abstract. We don't add key points for this paper.

To the Editor. —In his response to a question from Dr Drucker about fluoxetine (Prozac) and sexual dysfunction, Dr Hollander1states that sexual dysfunction with fluoxetine occurs in up to 1.9% of patients. Even though thePhysicians' Desk Reference2still carries this figure, this is no longer believed to reflect the true incidence of sexual dysfunction associated with fluoxetine and other antidepressants. Several studies reported sexual dysfunction with fluoxetine as being much higher, ranging from 7.8%3to 34%.4Orgasmic dysfunction associated with fluoxetine and other antidepressants in males has been described in these studies.3,4 Different management approaches have been suggested, including oral yohimbine,4switching to or adding buproprion, addition of buspirone, and various other approaches. For an excellent summary see the review by Seagraves.5 While depression may have been the source of sexual dysfunction in the case discussed inJAMA,1the patient's