To describe our experience with amphetamine/dextroamphetamine salts (AMP) as a treatment for delayed orgasm/anorgasmia (DO/AO).
We identified patients with DO/AO from September 2017 to September 2019. Baseline characteristics and patient-reported orgasmic latency time (OLT) were recorded. After extensive screening, patients were treated with AMP. Validated questionnaires were administered including International Index of Erectile Function, quantitative Androgen Deficiency in the Aging Male and Adult ADHD Self-Report Scale. OLT change, adverse effects, and patient satisfaction were assessed. Baseline characteristics were compared using chi-squared test. OLT changes were compared with one-way ANOVA. Multivariable logistic regression was performed to identify predictors of treatment success. P < 0.05 was statistically significant.
Seventeen men received AMP – 6 of 17 (35.3%) for AO and 11 of 17 (64.7%) for DO, with median follow-up 1.0 year (interquartile range [IQR] 1.0 year). Amongst responders, AMP improved subjective experience of sex in 8 of 17 (47.1%) patients (2/6 with AO). Of those, 6 of 17 (35.3%; 1/6 with AO) experienced reduced OLT or increased frequency of orgasm. Non-responders were older than responders, with median age 69.5 (IQR 4.3) vs 61.0 years (IQR 12.3; P = 0.024). There were no other significant differences in baseline characteristics among responders. Of note, 6 of 8 (75%) responders and 8 of 9 (88.9%) non-responders failed other treatment modalities prior to AMP. Among responders with DO and improved OLT, mean OLT decreased by 72.3% (40.7 to 11.1 minutes, P = 0.049) during intercourse. Minimal side effects were noted including insomnia and jitters, each in one patient respectively.
AMP as a treatment for AO/DO merits further investigation. Measurable improvements in OLT or frequency of orgasm occurred in more than a third of patients. Larger prospective multicenter studies with strict inclusion and exclusion criteria are warranted.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Urology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation.J Sex Med. 2008; 5: 1590-1606
- The epidemiology of the DSM-III psychosexual dysfunctions.J Sex Marital Ther. 1986; 12: 267-281
- Delayed orgasm and anorgasmia.Fertil Steril. 2015; 104: 1082-1088
- Amphetamine, past and present - a pharmacological and clinical perspective.J Psychopharmacol. 2013; 27: 479-496
- Lisdexamfetamine dimesylate (vyvanse) for the treatment of neurogenic anejaculation.Am J Mens Health. 2017; 11: 618-619
- A qualitative study of the relationship between methamphetamine abuse and sexual dysfunction in male substance abusers.Int J High Risk Behav Addict. 2016; 5: e29640
- The impact of illicit use of amphetamine on male sexual functions.J Sex Med. 2015; 12: 1694-1702
- The penile sensitivity ratio: a novel application of biothesiometry to assess changes in penile sensitivity.J Sex Med. 2019; 16: 447-451
- Cabergoline in the treatment of male orgasmic disorder-a retrospective pilot analysis.Sex Med. 2016; 4: e28-e33
- Risks of cardiac valve regurgitation and heart failure associated with ergot- and non-ergot-derived dopamine agonist use in patients with Parkinson's disease: a systematic review of observational studies.CNS Drugs. 2015; 29: 985-998
- Serotonin reuptake inhibitor-induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients.J Sex Marital Ther. 1997; 23: 165-175
- The acute effects of intranasal oxytocin administration on endocrine and sexual function in males.Psychoneuroendocrinology. 2008; 33: 591-600
- Pharmacotherapy for amphetamine dependence: a systematic review.Drug Alcohol Depend. 2018; 191: 309-337
- Systematic review: nonmedical use of prescription stimulants: risk factors, outcomes, and risk reduction strategies.J Am Acad Child Adolesc Psychiatry. 2020; 59: 100-112
- Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis.Lancet Psychiatry. 2018; 5: 727-738
- Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline.Clin Pharmacol Ther. 1997; 61: 476-487
- Bupropion-associated premature ejaculation.Pharmacopsychiatry. 2010; 43: 156-157
- Bupropion induced premature ejaculation.Turk Psikiyatri Dergisi. 2014; 25: 290
Modell, JG, May, RS. & Katholi, CR. Effect of bupropion-SR on orgasmic dysfunction in nondepressed subjects: a pilot study. J Sex Marital Ther26, 231–40.
Published online: April 30, 2020
Accepted: April 20, 2020
Received: February 24, 2020
© 2020 Elsevier Inc. All rights reserved.