Combination therapy with selective serotonin reuptake inhibitors and phosphodiesterase-5 inhibitors in the treatment of premature ejaculation

Abstract

We aimed to evaluate the effectiveness of paroxetine and tadalafil combination in the treatment of premature ejaculation (PE). A total of 150 primary (lifelong)PE patients were randomly distributed into three groups of 50 patients each. Group 1 received 20 mg paroxetine every day for 1 month, Group 2 received 20 mg tadalafil on demand 2 h before intercourse, and Group 3 received paroxetine and tadalafil on demand 2 h before intercourse. Intravaginal ejaculatory latency times (IELT) scores were evaluated at baseline, at the end of the first month of therapy and 1 month after discontinuation of the treatment, while International Index of Erectile Function (IIEF) questionnaire scores were evaluated both prior to and after the treatment. At the end of the first month of therapy, IELT scores were compared with the basal values and statistically significant changes were detected (60.6 ± 30.2-117.3 ± 67.3, 68.5 ± 21.4-110.2 ± 37.3, 71.56 ± 40.23-175.2 ± 60.2)(P < 0.01). IELT scores after discontinuation of treatment were found to be close to the baseline IELT scores (P > 0.05). IIEF scores were evaluated both prior to and after the treatment, and no statistically significant difference was detected (P > 0.05). It is concluded that utilisation of selective serotonin reuptake inhibitors (SSRI) and phosphodiesterase-5 inhibitors (PDE5i) combination before intercourse seems to provide significantly longer ejaculatory latency times as compared with SSRI alone for a long time in patients with PE.

Efficacy and safety of phosphodiesterase type 5 inhibitors on primary premature ejaculation in men receiving selective serotonin reuptake inhibitors therapy: a systematic review and meta-analysis

“…Fifteen articles lacked useful data (the values of each determinant of PE, such as IELT and coitus episodes). In total, 5 articles (Salonia et al ., ; Hosseini & Yarmohammadi, ; Mattos et al ., ; Lee et al ., ; Polat et al ., ) reporting data from a total of 5 RCTs that compared PDE5‐Is plus SSRIs with SSRIs were included in the analysis (Fig. ).…”

Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective serotonin reuptake inhibitors in men with premature ejaculation

“…Five studies [24,26,28,33,35] showed low risk in random sequence generation, and 4 studies [9,26,29,35] showed low risks in allocation concealment. Risk of participant blinding is high in 3 studies [24,25,32] and low in 9 studies. [9,26–30,33–35] Only 1 study [9] demonstrated high risk of outcome assessment blinding, while 9 studies [24,26–30,33–35] showed low risk.…”

“…[9,26–30,33–35] Only 1 study [9] demonstrated high risk of outcome assessment blinding, while 9 studies [24,26–30,33–35] showed low risk. Four studies [24,25,29,34] were found low risk in incomplete outcome data, accompanied with 9 studies [9,26–28,30–33,35] in high risk. High risk in selective reporting were discovered in 7 studies.…”

Combination or alone ? Which one is best in premature ejaculation treatment?

“…In a study of premature ejaculation in which the use of a combination of selective serotonin reuptake inhibitors and phosphodiesterase type 5 inhibitors was examined, this combination therapy was shown to have a prolonged ejaculation time that was significantly longer than that of selective serotonin reuptake inhibitors alone [11] .…”