Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial

Abstract

Purpose: To compare the effi cacy and safety of available selective serotonin reuptake inhibitors (SSRIs) in order to fi nd the most effective drug with the least number of side effects in treatment of premature ejaculation (PE). Materials and Methods: This study was a randomized clinical trial. Four hundred and eighty patients with PE in the 4 groups referred to Imam Reza hospital Tehran, Iran from July 2018 to February 2019 were enrolled in the study. The patients received sertraline 50mg, fl uoxetine 20mg, paroxetine 20mg and citalopram 20mg, every 12 hours daily. The intravaginal ejaculatory latency time (IELT) before treatment, fourth and eighth weeks after treatment was recorded by the patient's wife with a stopwatch. Results: Mean IELT before, 4 and 8 weeks after treatment in four groups were: sertraline 69.4±54.3, 353.5±190.4, 376.3±143.5; fl uoxetine 75.5±64.3, 255.4±168.2, 314.8±190.4; paroxetine 71.5±69.1, 320.7±198.3, 379.9±154.3; citalopram 90.39±79.3, 279.9±192.1, 282.5±171.1 seconds, respectively. The ejaculation time signifi cantly increased in all groups (p <0.05), but there was no signifi cant difference between the groups (P=0.75). Also, there was no signifi cant difference in drugs side effects between groups (p >0.05). The most common side effects were drowsiness and dyspepsia, which were not severe enough to cause discontinuation of the drug. Conclusions: All available SSRIs were effective and usually had no serious complications. In patients who did not respond to any of these drugs, other SSRI drugs could be used as a salvage therapy.

The network meta‐analysis of “on‐demand” and “daily” use of paroxetine in treating men with premature ejaculation from randomized controlled trials

“…Twenty‐four articles (Abdel‐Hamid et al, 2001; Abu El‐Hamd & Abdelhamed, 2018; Alghobary et al, 2010; Arafa & Shamloul, 2007; Gameel et al, 2013; Gong et al, 2011; Hamidi‐Madani et al, 2018; Homayuonfar et al, 2018; Kirecci, Simsek, Gurbuz, et al, 2014; Kirecci, Simsek, Yuksel, et al, 2014; McMahon & Touma, 1999; Moudi & Kasaeeyan, 2016; Otunctemur et al, 2014; Ozcan et al, 2015; Polat et al, 2015; Safarinejad, 2006; Salonia et al, 2002; Siroosbakht et al, 2019; Sunay et al, 2011; Ur Rehman et al, 2020; Waldinger, Hengeveld, & Zwinderman, 1994, 1997; Waldinger et al, 2004; Wang et al, 2007) with 25 RCTs including 2,308 patients were used to evaluate the efficacy and safety of “on‐demand” and “daily” paroxetine in treating PE. A flow diagram of selection process was shown in Figure 1.…”

An update on the treatment of premature ejaculation: A systematic review

“…Partner sexual satisfaction and IIEF rate were greater with 90 mg fluoxetine, but no statistical difference was found. Siroosbakht et al, 2019 [ 151 ] RCT Fluoxetine 20 mg Paroxetine 20 mg Citalopram 20 mg Sertraline 50 mg 8 weeks 480 Mean (SD) IELT before, 4 and 8 weeks after treatment in four groups was: sertraline 69.4 (54.3), 353.5 (190.4), 376.3 (143.5) s; fluoxetine 75.5 (64.3), 255.4 (168.2), 314.8 (190.4) s; paroxetine 71.5 (69.1), 320.7 (198.3), 379.9 (154.3) s; citalopram 90.39 (79.3), 279.9 (192.1), 282.5 (171.1) s, respectively. IELT significantly increased in all groups ( P < 0.05), but there was no significant difference between the groups ( P = 0.75).…”

“…Pharmacological interventions (Table 3) [24,26,27,32,47,48,[50][51][52][55][56][57][58][59]66,67,72,73,[76][77][78][79]81,[84][85][86][87]89,90,116,[151][152][153][154][155][156][157][158][159][160][161][162][163]…”

Prevalence of antidepressant-induced sexual dysfunction among psychiatric outpatients attending a tertiary care hospital

“…In fact, fluoxetine and paroxetine (20 mg) is effective in the management of premature ejaculation. 2,3 Moreover, the authors reported 32 patients sexual dysfunction were treated with mirtazapine, while mirtazapine does not cause sexual dysfunction as other selective serotonin reuptake inhibitors (SSRIs). 4 In addition, venlafaxine, a norepinephrine-serotonin reuptake inhibitor, was reported as an effective drug in the management of premature ejaculation.…”