Encompassing a broad spectrum of conditions, ejaculatory dysfunction (EjD) includes premature ejaculation (PE), anejaculation(AE), and retrograde ejaculation (RE). This chapter discusses the incidence rate, diagnosis methods and treatment options available for treating EjD. Behavioral/psychological treatments, topical anesthetic agents, serotonin reuptake inhibitors (SSRIS) and phosphodiesterase (PDE)-5 inhibitors are the treatment options available for PE. Penile vibratory stimulation, electroejaculation, and surgical sperm extraction from the epididymis or testes are all successful methods for obtaining sperm for later use with ART in AE where the success rates of other methods are low. Common causes of RE can be categorized as anatomic, neurogenic, pharmacological, or idiopathic in origin. Anticholinergics, alpha-adrenergic agonists, or similar combinations may be used to modulate bladder neck activity but are not as effective as imipramine, which should be considered the first-line therapeutic agent for RE.

This chapter discusses the clinical data concerning pharmacodynamic (PD) interactions of antiepileptic drugs (AEDs) with antidepressants (ADs), antipsychotics (APs), central nervous system (CNS) stimulants, anesthetic agents, analgesics and anti-inflammatory drugs. Experimental and clinical data suggest that AEDs and ADs have similar mechanisms of action which could result in favorable and/or unfavorable PD interactions depending on the particular agents involved. AP and AEDs are frequently co-administered and PD interactions concerning their effects on psychosis and seizure threshold are possible. At low doses, stimulants are co-administered with AEDs in the epileptic patient and seem to have beneficial PD interactions. Among anesthetic agents, lidocaine is of particular interest. Treatment of anesthetic-induced convulsions can be particularly difficult because of many possible unfavorable PD interactions. AEDs, analgesics and anti-inflammatory drugs can often be co-administered for the treatment of some forms of pain.