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May 17, 1995

Fluoxetine and Sexual Dysfunction-Reply

JAMA. 1995;273(19):1490. doi:10.1001/jama.1995.03520430025022

In Reply.  —Since my answer to the question of fluoxetine and sexual dysfunction, JAMA has received numerous letters disputing my statement that sexual dysfunction occurs in "up to 1.9% of patients." I wish that I could claim a typing error, but I chose to quote the Physicians' Desk Reference in search of a rate of sexual dysfunction to explain the patient's delayed orgasm. Clearly, the rate of delayed ejaculation or anorgasmia is much higher than 1.9%. Indeed, drugs that inhibit serotonin reuptake may have a therapeutic effect in patients with premature ejaculation. At this time, the letters I have received from JAMA quote rates of 7.8% to 75% of patients having problems with sexual dysfunction.1,2Many articles address overall sexual dysfunction, including anorgasmia in patients receiving fluoxetine, but careful perusal shows small numbers of men studied. Zajecka et al1 suggest a 7.8% incidence of sexual dysfunction in men

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