Polypharmacy and delayed ejaculation in an older adult

Authors

Keywords:

angiotensin-converting enzyme inhibitors, benzodiazepines, ejaculatory dysfunction, elderly, hydroxymethylglutaryl-CoA reductase inhibitors, polypharmacy, selective serotonin reuptake inhibitors

Abstract

Introduction: Polypharmacy can be observed in approximately 50 % of older adults. Delayed ejaculation usually increases with age and may be associated with polypharmacy. It is mandatory to review sexual health in patients taking multiple medications.

Objective: To present a case of diagnosis and management of generalized delayed ejaculation induced by polypharmacy in an elderly patient with comorbidity.

Clinical Case: An adult over 69 years of age with comorbidity of panic disorder in remission with alprazolam, arterial hypertension controlled with amlodipine and enalapril, dyslipidemia managed with atorvastatin and migraine managed with fluoxetine. Three years after starting fluoxetine and reducing alprazolam, limitations in achieving orgasm and ejaculation occurred. A diagnosis of generalized delayed ejaculation induced by polypharmacy (alprazolam, enalapril, and fluoxetine) was made. The symptom resolved completely one month after fluoxetine withdrawal.

Conclusions: Polypharmacy can negatively affect sexual response in older adults. It is important to review sexual symptoms during the follow-up of this group of patients and consider drug interactions among the causes.

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Author Biographies

Adalberto Campo-Arias, Universidad del Magdalena

Médico psiquiatra, especialista en epidemiología, magíster en salud sexual y reproductiva y profesor asociado, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia

Robin Andrés Grubert, Asociación de Psiquiatras Argentinos (APSA), Buenos Aires

MD, residente de psiquiatría

Carlos Alfonso Reyes-Ortiz, Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, FL,

MD, geriatra, profesor asociado

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Published

2025-08-16

How to Cite

1.
Campo-Arias A, Grubert RA, Reyes-Ortiz CA. Polypharmacy and delayed ejaculation in an older adult. Rev. cuba. med. mil [Internet]. 2025 Aug. 16 [cited 2026 Feb. 12];54(3):e025076154. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/76154

Issue

Vol. 54 No. 3 (2025): July - September

Section

Case Presentation

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Copyright (c) 2025 Adalberto Campo-Arias, Robin Andrés Grubert, Carlos Alfonso Reyes-Ortiz

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