To the Editor.
—In his response to a question from Dr Drucker about fluoxetine (Prozac) and sexual dysfunction, Dr Hollander1 states that sexual dysfunction with fluoxetine occurs in up to 1.9% of patients. Even though the Physicians' Desk Reference2 still 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%3 to 34%.4 Orgasmic dysfunction associated with fluoxetine and other antidepressants in males has been described in these studies.3,4Different management approaches have been suggested, including oral yohimbine,4 switching to or adding buproprion, addition of buspirone, and various other approaches. For an excellent summary see the review by Seagraves.5While depression may have been the source of sexual dysfunction in the case discussed in JAMA,1 the patient's
Balon R. Fluoxetine and Sexual Dysfunction. JAMA. 1995;273(19):1489. doi:10.1001/jama.1995.03520430025019