A rare symptom in posttraumatic stress disorder: Spontaneous ejaculation

PATIENT Male, 25 FINAL DIAGNOSIS: Post Traumatic Stress Disorder Symptoms: Insomnia • nightmares • spontaneous ejaculation MEDICATION Paroxentine Clinical Procedure: - Specialty: Psychiatry. OBJECTIVE Unusual clinical course. BACKGROUND Sexual dysfunction is reported to occur more frequently in posttraumatic stress disorder (PTSD) patients than in the general population. Herein, we present the case of a patient with spontaneous ejaculation that developed when severity of PTSD symptoms increased. CASE REPORT Our patient was a 25-year-old single man admitted to a psychiatric polyclinic because of PTSD symptoms and concurrent spontaneous ejaculations. He was diagnosed with PTSD after clinical interviews. Organic pathology to explain spontaneous ejaculations was not detected. Paroxetine treatment was initiated and PTSD symptoms and frequency of spontaneous ejaculations were decreased at the clinical follow-up. CONCLUSIONS Assessment of the presented case in the light of the literature indicates that his re-experiencing (flashbacks, nightmare) and hyperarousal (symptoms of anxiety specific to PTSD) led to an increase in adrenergic system activation and, consequently, spontaneous ejaculation without sexual stimulus. The effect of Paroxetine in decreasing the frequency of spontaneous erection and ejaculation in the presented case is thought to have occurred via control of PTSD symptoms and their adverse effects on ejaculation. Treatment based on a consideration of PTSD symptoms and autonomic instability might increase the positive outcome rate in such patients.