Abstract
Ejaculatory failure (anorgasmia) has frequently been reported with imipramine and other tricyclic antidepressants (TCAD). A 44-year old man treated for panic disorder reported ejaculatory failure with 150 mg. imipramine and also with antihistaminics suggesting an anticholinergic mechanism. Since anorgasmia has been reported to diminish with change to a less anticholinergic antidepressant, he was given nortriptyline, 75 mg/day. He regained ejaculatory potency on this medication with continued control of his panic disorder. The antiadrenergic effects of imipramine may inhibit both emission of semen and ejaculation (orgasm), whereas the anticholinergic effects can cause anorgasmia with normal semen emission.

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