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ABSTRACT
Sexual dysfunctions such as diminished libido, erectile dysfunction, arousal problems, or delayed orgasm are common side effects of antidepressant medication. However, spontaneous ejaculation is a rare side effect caused by antidepressants. Several case of spontaneous ejaculation have been reported about escitalopram, venlafaxine and reboxetine in the literature. In this paper, a 46-year-old man who developed spontaneous ejaculation with duloxetine is discussed. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):14-16)
Keywords: spontaneous ejaculation, duloxetine, antidepressant
Duloksetine bagli gelisen spontan ejekülasyon
ÖZ
Sertlesme islev bozuklugu, uyarilma sorunlari, libido azalmasi veya orgazm gecikmesi gibi cinsel islev bozukluklari antidepresan tedavinin sik görülen yan etkileri arasinda yer almaktadir. Ancak, antidepresanlara bagli spontan ejakülasyon nadir bir yan etkidir. Bu güne kadar essitalopram, venlafaksin ve reboksetin kullanimina bagli spontan ejakülasyon olgulari bildirilmistir. Bu yazida duloksetinle spontan ejakülasyon gelisen 46 yasindaki bir erkek olgu ele alinacaktir. (Anadolu Psikiyatri dergisi 2016; 17(Ek.3):14-16)
Anahtar sözcükler: Spontan ejekülasyon, duloksetin, antidepresan
INTRODUCTION
Duloxetine is a potent dual reuptake inhibitor of serotonin and norepinephrine (SNRI) with comparable affinities to both transporter sites.1 It is widely used for treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and several chronic pain conditions.2 Duloxetine has sexual side effects as well as other antidepressants. Although, duloxetine is less likely causes sexual dysfunction compared to other antidepressants,3 it has more sexual adverse events in men than women.4 Spontaneous ejaculation is a rare adverse event caused by antidepressants.5 There are several reports of spontaneous ejaculation due to escitalopram, venlafaxine and reboxetine.5,9,10 In this case we aim to report a patient with spontaneous ejaculation with duloxetine throughout a year.
CASE
A 46-year-old man was referred to psychiatry clinic for repetition of his prescription. He was on duloxetine 60 mg/day. He was prescribed duloxetine one year ago when he admitted to a psychiatry clinic with anhedonia, sleep disturbance, lack of appetite, suicidal thoughts, ruminations, pain in all over the body, diarrhea and constipation, anxiety, palpitation. He was diagnosed with MDD. Duloxetine 30 mg/day initiated and increased to 60 mg/day after one month. Patient described that spontaneous ejaculation started after increasing duloxetine to 60 mg/day. It was happening every day, mostly after micturition, occasionally after defecation without sexual arousal. Additionally patient was complaining about loss of...