Sexual Dysfunctions Induced by Pregabalin

Pregabalin (PGB) is a gabapentinoid (ie, GABA analog), which has been Food and Drug Administration-approved for treatment of partial epilepsy in adults and neuropathic pain. It also has off-label uses for the treatment of generalized anxiety disorders, fibromyalgia, and tension headache and prevention of migraine. Few cases were reported with sexual dysfunctions (SDs) as adverse effects of PGB and gabapentin, and the majority were dose related (≥900 mg/d for gabapentin). This study aimed to determine the frequency and types of SDs induced by PGB and the temporal relation to its use.

We presented case series of patients (n = 75) treated with PGB for different indications (sciatica, atypical facial pain, chronic tension headache, transformed migraine, fibromyalgia, and generalized anxiety disorder and developed different aspects of SDs).

In this case series, SDs were noticed with PGB in 41.33% (n = 31) (men, 13 [50%]; women, 18 [36.73%]), which included erectile dysfunction (n = 16, 51.61%), anorgasmia (n = 10, 32.26%), and loss of libido (n = 11, 35.48%). Sexual dysfunctions occurred within weeks after the use of PGB and were not dose related. They occurred with low therapeutic PGB doses (50-100 mg/d). Discontinuation of PGB resulted in improvement of SDs within weeks. To conclude, SDs are not infrequent adverse effects of PGB therapy. Pregabalin can induce erectile dysfunction, loss of libido, and anorgasmia. Sexual dysfunctions induced by PGB are not dose related. It is important for the clinician to acknowledge and encourage discussion regarding sexual function with patients and inquire about the impact of PGB on sexual function.