Anorgasmia with gabapentin may be common in older patients

Abstract

Background: Gabapentin is commonly used to treat neuropathic pain, seizures, and bipolar disease in older and elderly patients. It is preferred for its well-tolerated side effect profile. Anorgasmia with gabapentin use is reported, with most cases in young patients.

Case summary: This report describes 4 older patients who experienced anorgasmia while taking gabapentin. Of 15 patients initiated on gabapentin in 18 months, 3 male patients aged 73, 76, and 78 years experienced dose-dependent anorgasmia. A fourth case, a 59-year-old female patient, was noted in another clinic. Orgasm returned when gabapentin was reduced or stopped. Although this is not a blinded study, anorgasmia in 3 of 15 patients newly initiated on gabapentin (3 of 11 in those aged >50 years) seems to represent a much higher incidence than the originally reported <1% in epilepsy clinical trials. Outside of erectile dysfunction, clinicians rarely ask older patients about sexual function.

Conclusion: Gabapentin-associated anorgasmia may be more common in older patients and appears to be dose dependent.