Anorgasmia with Gabapentin May Be Common in Older Patients

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.