Antidepressants in the treatment of premature ejaculation.

The SSRI antidepressants have emerged as effective new treatment for patients with premature ejaculation whether or not these patients suffer from depression. Clomipramine, fluoxetine, paroxetine, and sertraline seem to be a safe treatment option for patients with premature ejaculation, especially in cases of failed psychological treatment, in rejection of psychological treatment, and when partners are unwilling to cooperate in treatment. Further controlled and larger studies that focus on clinically relevant issues such as dose, length of treatment, maintenance of beneficial effects after treatment discontinuation, and the combination of pharmaco- and behavior therapy for premature ejaculation are warranted. Other medications, such as benzodiazepines, may be useful in some cases of premature ejaculation.

Balon R 《JOURNAL OF SEX & MARITAL THERAPY》

Clinical inquiries. What's the best drug treatment for premature ejaculation?

Mercado MG ，Kimmer SL ，Holman JR ，Wanserski G ，Lo V ... -  《-》

Valproate pretreatment for the difficult-to-treat patient with OCD.

Deltito JA 《JOURNAL OF CLINICAL PSYCHIATRY》

Pharmacologic treatment of rapid ejaculation.

Althof SE 《PSYCHIATRIC CLINICS OF NORTH AMERICA》

Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: a double-blind, placebo controlled study.

We compared the efficacy and safety of fluoxetine, sertraline, clomipramine and placebo for the oral pharmacotherapy of premature ejaculation. The study included 36 men (mean age 44 years) who had intravaginal ejaculation latency of less than 2 minutes. Patients took each of 3 drugs and the placebo consecutively during a 4-week period per each agent. Efficacy and side effects data were obtained by a self-reported patient questionnaire that rated intravaginal ejaculation latency, sexual satisfaction of patient and partner, and possible side effects. After 4 weeks of treatment with placebo, fluoxetine, sertraline and clomipramine the mean intravaginal ejaculation latency time was significantly increased from 46 seconds to 2.27 minutes, 2.30 minutes, 4.27 minutes and 5.75 minutes, respectively (all p <0.01). However, treatment with clomipramine or sertraline caused a greater increase in mean intravaginal ejaculation latency time than fluoxetine or placebo (p <0.01). Patient sexual satisfaction rate after treatment with clomipramine was significantly higher (p <0.05) than with sertraline, fluoxetine or placebo. Partner sexual satisfaction rate was also higher with clomipramine than with sertraline or fluoxetine but no statistical difference was found. The incidence of side effects with clomipramine was significantly higher (p <0.05) compared to that of fluoxetine, sertraline and placebo, while no significant difference among sertraline, fluoxetine and placebo was noted. In men with premature ejaculation clomipramine was the most useful drug in terms of efficacy. Treatment with sertraline was nearly as effective and had a lower incidence of side effects.

Kim SC ，Seo KK 《JOURNAL OF UROLOGY》