番茄社区

NASHVILLE -- Very low doses of amphetamine/dextroamphetamine (Adderall) can be a useful treatment for men who have difficulty achieving orgasm, a researcher reported here.

Among men who took 2.5 to 10 mg doses of the drug 1 to 2 hours before sexual activity, roughly half reported improvement in delayed orgasm or anorgasmia. Two of five men who could not achieve an orgasm before starting the treatment were able to do so after taking the drug, according to Matthew Ziegelmann, MD, of Mayo Clinic in Rochester, Minnesota.

However, the study included follow-up data on 13 men treated at two treatment centers with low-dose amphetamine so more research is "mandatory," Ziegelmann and colleagues stated in a poster at the Sexual Medicine Society of North America fall meeting.

Co-author Petar Bajic, MD, of Rush University Medical Center in Chicago, told 番茄社区 that off-label use of the drug appears to help some men who do not respond to other treatments, such as psychosexual counseling, penile vibratory stimulation, and drug therapies, including selective serotonin reuptake inhibitors (SSRIs) and testosterone supplementation.

"This should be considered another tool in our armamentarium of treatments for delayed orgasm and anorgasmia in men," Bajic said. "The guys I feel most comfortable offering it to are the ones who tell me they have focus issues [during sex]."

Certified sexuality educator Sue Goldstein, of San Diego Sexual Medicine, told 番茄社区 that while amphetamines may help a carefully selected subset of men who seek treatment for delayed orgasm or anorgasmia, the benefit in these men would have to be weighed against the risk for addiction.

"Even at low doses this is a concern, so you would need to screen men very carefully," said Goldstein, who was not involved in the study.

She noted that in both men and women, low desire, or hypoactive sexual desire disorder (HSDD), often leads to delayed orgasm or the inability to achieve orgasm at all.

Two drug treatments -- bremelanotide () and flibanserin (Addyi) -- have been approved for HSDD in women, and the drugs are also used off-label in men.

"We now have these two treatments, so I don't know if I would risk addiction by giving [Adderall]," Goldstein said. "We've used low-dose Adderall in the past to help both male and female patients with focus issues, but we don't use it anymore."

Ziegelmann explained that "delayed orgasm or anorgasmia refers to persistent inability to achieve orgasm, despite adequate sexual arousal. This is not an uncommon condition."

Studies have suggested that around , but it is widely believed that the condition is underreported.

Ziegelmann noted that for many men with the condition, available treatments do not work well. He added that "using a stimulant medication to treat sexual dysfunction is not without some evidence basis."

Amphetamine/dextroamphetamine improves attention, focus and wakefulness, by increasing the concentration of norephinephine, dopamine, and other neurotransmitters. "Here, we hypothesized that, due to these central mechanisms that ultimately lead to improved attention and focus, we could use Adderall to successfully treat delayed orgasm and anorgasmia," Ziegelmann said.

A total of 15 men (median age 58) were treated with amphetamine/dextroamphetamine, including six with (40%) anorgasmia and nine with delayed orgasm. Of these men, 33.3% had stable anxiety or depression.

All of the men reported delayed or absent orgasms during penetrative intercourse and 80% also had difficulties with self stimulation.

Seven of the men had previously been treated with the hormone-imbalance drug cabergoline, two with the pituitary hormone oxytocin, five with psychosexual therapy, seven with PDE5-inhibitors and 4 with penile vibration.

Data on 13 patients were included in the current analysis, and seven of those reported subjective success with the stimulant, including two of five men with anorgasmia.

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