Objective
To describe our experience with amphetamine/dextroamphetamine salts (AMP) as a treatment
for delayed orgasm/anorgasmia (DO/AO).
Methods
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.
Results
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.
Conclusion
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.
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Article info
Publication history
Published online: April 30, 2020
Accepted:
April 20,
2020
Received:
February 24,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
