To the Editor: We thank Richard Balon, M.D., for his thoughtful response to our article. We agree that our results represent pilot work and leave many questions unanswered. As we stated, some of the observed effects may be explained by 1) a ceiling effect—e.g., baseline orgasm delay and dissatisfaction with orgasm in women may have precluded further deterioration; 2) reporting differences between men and women; and 3) differences in the timing of onset of change. As in the study by Labatte et al. that Dr. Balon cites, treatment-emergent sexual dysfunctions reported at 2 and 4 weeks in our study were larger than those reported at 6 weeks and may have continued to decline if followed further.