Three cases of orgasmic inhibition by clomipramine are reported, one in a male and two infernales. All were depressed patients with obsessive-compulsive features. Orgasmic dysfunction manifested shortly after beginning clomipramine therapy despite a return of libido as the depression lifted. Two of these patients switched to desipramine which led to a resolution of sexual dysfunction while maintaining the patients depression free. The third patient manipulated dosage times to diminish the orgastic problem.
Strong anticholinergic and/or anti-adrenergic properties of clomipramine are suspected to underlie the development of this problem.
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