The chemotherapy of impotence and frigidity

The development of psychopharmaceutical agents in the past ten years has changed considerably the nature of psychiatric therapy throughout the world. It has cllanged the nature of the psychiatric hospital population. It has changed the environment in hospitals, allowing for the development of community psychiatric programs, day hospitals, and the open-door program. In addition, it has changed the nature of psychiatric office practice. Greater numbers of patients and a wider variety of disorders can now be treated in outpatient practices because of the economical and successful use of rapid acting psychopharmaceuticals in the treatrnent of psychiatric conditions. Patients with less severe psychiatric disorders such as those with neurotic depressive reactions, those with depressive psychoses who are not sick enough to need electro-convulsive shock therapy or hospitalization, and others with marginal adaptation comprise the categories of patients who have been especially benefited by the development of the antidepressant drugs. The successful treatment of these patients has suggested the need to reformulate psychopathological concepts and treatment of sexual abnormalities. Earlier studies of sexual abnormalities, particularly the so-called perversions, led to a theoretical model of explaining sexual difficulties which later was applied to more widely occurring sexual problems such as impotence and frigidity. Recent experience in tlle treatment of depressive disorders has provided evidence that many of these states of reduced libido or inhibited libido are in fact to be differentiated from states of "perverted libido" that is, abnormalities in the methods and manners of sexual gratification. While clinicians have long known that the vast majority of depressed people (neurotic and psychotic) have reduced libido, we are beginning to learn now that the vast majority of people complaining about reduced libido are in fact cases of depression. In clinical practice the complaint of reduced libido is sometimes the speciSc presenting complaint, or else it accompanies complaints of irritability, lack of energy, lack of interest, the feeling that nothing is worthwhile