ABSTRACT:
Background:Sexual dysfunction is a common adverse effect of antidepressant therapy and may significantly affect treatment adherence and quality of life. Reboxetine, a selective norepinephrine reuptake inhibitor (NRI), is generally considered to have a lower incidence of sexual adverse effects compared with other antidepressants. Reports of painful ejaculation associated with reboxetine are rare.Case Presentation: A 45-year-old male diagnosed with Major Depressive Disorder was initiated on reboxetine 4 mg/day due to predominant symptoms of psychomotor retardation. Three weeks after starting treatment, he developed painful ejaculation despite having no prior history of sexual dysfunction. Comprehensive urological evaluation, including laboratory investigations, prostate-specific antigen testing, uroflowmetry, and urinary system ultrasonography, revealed no abnormalities. Reboxetine was discontinued, and the patient was switched to fluoxetine 20 mg/day.Results: The painful ejaculation resolved completely following discontinuation of reboxetine. No underlying organic cause was identified, suggesting a probable causal relationship between reboxetine therapy and the adverse event.Conclusion:Although Reboxetine is generally associated with a favorable sexual side-effect profile, clinicians should be aware of the possibility of rare sexual adverse effects such as painful ejaculation. Careful monitoring and prompt recognition of these symptoms may improve treatment adherence and patient quality of life.