Association of fluoxetine and return of sexual potency in three elderly men

Fluoxetine, a highly specific serotonin reuptake inhibitor, has been reported to cause sexual dysfunction in a minority of patients. Although priapism has been associated with other serotonergic antidepressants, no published reports have correlated restoration of sexual potency with use of fluoxetine.

The case histories of three geriatric patients treated with fluoxetine for depression or obsessive compulsive disorder are presented.

Three patients with histories of impotence experienced a return of sexual potency after treatment with fluoxetine. In two of the cases, the patients had documented histories of vascular disease, which their internists had identified as the cause of their impotence. The improvement in sexual response was seemingly unrelated to abatement of depression or obsessive compulsive disorder, and there was no description of priapism by any of the patients.

Sexual side effects of fluoxetine may be more variable than previously thought. Animal models showing paradoxical or opposing responses to serotonin-enhancing agents may apply to human sexual functioning as well.