Reactions 1476, p30 - 2 Nov 2013

Pregabalin

Anorgasmia: 3 case reportsThree patients developed anorgasmia while receiving

pregabalin for epilepsy.A 35-year-old man experienced partial seizures with

secondary generalisation since the age of 10 years that wererefractory to oxcarbazepine and valproate. He was started onpregabalin, gradually titrated up to 300 mg/day [route notstated]. He subsequently reported anorgasmia and delayedejaculation [duration of therapy before reaction onset notstated], which led to severe sexual dissatisfaction. The man’spregabalin was gradually discontinued. Lacosamide wascommenced, and his sexual performance was restored.

A 24-year-old man was evaluated for episodes of complexpartial seizures without generalisation. He achieved moderateseizure control with carbamazepine. Due to a concurrentgeneralised anxiety disorder, he was initiated on pregabalin,which was titrated up to 300 mg/day [route not stated]. Hesubsequently reported severe anorgasmia, followed by loss oflibido and intermittent secondary erectile dysfunction. Theman’s pregabalin was gradually discontinued and he wascommenced on levetiracetam. At 12 months’ follow-up, therewere no further seizures or sexual problems.

A 28-year-old man experienced several complex partialseizures, followed at times by secondary generalisation. Hewas initiated on oxcarbazepine, with no improvement inseizure control. Pregabalin [route and dosage not stated] wasadded to therapy, and he became nearly free of seizures.However, he began to complain of anorgasmia [duration oftherapy before reaction onset not stated]. This caused highlevels of sexual dissatisfaction and relationship distress. Theman’s pregabalin was gradually discontinued. He wascommenced on levetiracetam, which improved his seizurecontrol and totally restored his sexual performance by18 months’ follow-up.

Author comment: "Herein, we describe three maleindividuals with epilepsy presenting with clear drug-relatedanorgasmia after pregabalin add-on treatment".Calabro RS, et al. Anorgasmia during pregabalin add-on therapy for partialseizures. Epileptic Disorders 15: 358-361, No. 3, Sep 2013. Available from: URL:http://dx.doi.org/10.1684/epd.2013.0592 - Italy 803095066

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