UM CASO DE EJACULAÇÃO RETARDADA EM PACIENTE COM TAG E TOC: A CASE OF DELAYED EJACULATION IN A PATIENT WITH GAD AND OCD
Delayed ejaculation (DE) is an uncommon condition for which there is no consensus regarding drug treatment. It is essential that organic etiologies are properly diagnosed and treated, as is the case with hypothyroidism, androgenic deficiency and delays due to the action of medications, including sev...
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2020 |
| País: | Brasil |
| Recursos: | Sociedade Brasileira de Estudos em Sexualidade Humana (SBRASH) |
| Repositório: | Revista Brasileira de Sexualidade Humana (Online) |
| Idioma: | português |
| OAI Identifier: | oai:ojs.rbsh.org.br:article/676 |
| Acesso em linha: | https://www.rbsh.org.br/revista_sbrash/article/view/676 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Ejaculação Retardada Ansiedade Obsessivo-compulsivo Medicamentos Delayed Ejaculation Anxiety Obsessive-compulsive Medications |
| Resumo: | Delayed ejaculation (DE) is an uncommon condition for which there is no consensus regarding drug treatment. It is essential that organic etiologies are properly diagnosed and treated, as is the case with hypothyroidism, androgenic deficiency and delays due to the action of medications, including several antidepressants. However, many patients have ejaculatory delay and anorgasmia due only to psychogenic reasons. Thus, psychiatry diagnosis is very important for choosing the best drug approach for each individual. In the clinical case presented, the individual has symptoms of Generalized Anxiety Disorder (GAD) in addition to the sexual condition of DE, Obsessive Compulsive Disorder (OCD) and a history of Excessive Sexual Impulse. All possible organic causes were duly ruled out. Therefore, drug treatment required drugs that act on generalized anxiety and OCD, not worsening the DE and, if possible, improving it. As the action of serotonin on the 5HT2A post synaptic receptor tends to inhibit the medullary reflex of orgasm, Mirtazapine (anti 5HT2A) was chosen. It also helped to improve his insomnia by the antihistamine effect. Buspirone was added due to the fact that it is a dopaminergic anxioliytic, which can improve both sexual desire eventually impaired by Mirtazapine and DE itself. |
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