(257) Is Adderall Effective in the Treatment of Delayed Ejaculation? A Continued Retrospective Analysis

Abstract

Abstract Introduction Numerous treatments have been evaluated for delayed ejaculation (DE), but many are considered sub-optimal and have limited data support. This results in significant patient distress and leads to confusion for providers on the best treatment recommendations for this difficult sexual medicine condition. Preliminary studies have shown as needed low dose Adderall (amphetamine/dextroamphetamine) to provide improvement in symptoms and orgasmic latency time in patients with delayed orgasm or anorgasmia. Objective The objective of this study is to retrospectively assess the efficacy of Adderall treatment in men with DE, as well as associated comorbidities. The first phase of this study establishes baseline characteristics of patients that were prescribed Adderall for DE. The second phase of this study includes a survey to assess optimal frequency and dosage based on patient satisfaction and any side-effect profile. Methods Patients were identified from an AllScripts query using ICD-10 codes of “Retarded Ejaculation” (N53.11) and “Other ejaculatory dysfunction” (N53.19) and retrospective record review identifying men with DE over 18 years old having been prescribed Adderall. Objective data was collected including biothesiometry results, total testosterone levels, penile prosthesis placement, previous circumcision, and presence of co-morbidities such as erectile dysfunction, diabetes, depression, prostate cancer, smoking and neurologic disorders. Success was defined as subjective reduced time to orgasm per patient report. The second phase of this study includes contacting this study group via survey (RedCAP and phone) to assess the effective dose and side effects of using Adderall for DE. Results 35 men were treated with Adderall for DE. In total, Adderall was shown to be preliminarily effective in 31% of patients (11/35) with 40% unable to be determined from retrospective review. The majority of patients were started on 5mg Adderall and titrated up to 20mg as needed taken 1-4 hours before sexual activity. Baseline patient characteristics are detailed in Table 1. The average age of patients was 59 years old with 57% of patients over the age of 70 years old. 65% (20/35) patients had abnormal biothesiometry results. There were no adverse events reported. Conclusions Low dose Adderall resulted in preliminary improvement in at least 31% of patients with DE. Further patient surveillance is planned, in part to determine if particular patient characteristics may be better for this approach. It is critical to avoid misuse of this drug and larger prospective studies are still needed. This study supports the use of Adderall as another treatment option for this difficult and poorly understood condition. Disclosure No.