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

Jin, Kun; Deng, Liangliang; Qiu, Shi; Tu, Xiang; Li, Jiakun; Bao, Yige; Yang, Lu; Wang, Qiang

doi:10.1097/md.0000000000013342

Cited by 7 publications

(1 citation statement)

References 41 publications

(76 reference statements)

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“…However, these articles only draw conclusions about the therapeutic effects of a single oral drug or are limited to the comparison of SSRI and PDE5i. The comparison of the efficacy and safety between nonoral drug treatment and different kinds of drugs has not been reported in related articles, and previous articles have not covered recent clinical studies (Du et al, 2019;Jin et al, 2018;Martyn-St James et al, 2017;Qin et al, 2019;Yang et al, 2013). Because of the diversity of clinical treatments and the lack of head-to-head experiments, ordinary meta-analysis does not effectively compare the effects of different interventions.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta‐analysis

et al. 2020

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To assess the comparative efficacy and safety of drug treatments for premature ejaculation. A systemic review and Bayesian network meta‐analysis were executed on randomised controlled trials of drug interventions for premature ejaculation. Intravaginal ejaculation latency time and related adverse effects were outcome measures. A total of 44 RCTs with 11,008 patients were included in our NMA. In therapy <8 weeks, the ranking of drug efficacy was topical creams >selective serotonin reuptake inhibitor (SSRI)+ phosphodiesterase 5 inhibitor (PDE5i) > PDE5i > sertraline > clomipramine > paroxetine > dapoxetine 60 milligram (mg) > dapoxetine 30 mg > fluoxetine>citalopram > duloxetine>placebo. In therapy ≥ 8 weeks, the ranking of drug efficacy was SSRI + PDE5i > topical creams > paroxetine > tramadol > PDE5i > fluoxetine > dapoxetine 60 mg > dapoxetine 30 mg > clomipramine>citalopram > placebo. For total adverse events, clomipramine, dapoxetine 30 mg, dapoxetine 60 mg, paroxetine, PDE5i, SSRI + PDE5i and tramadol had a higher risk than placebo. In conclusion, in ≥8 weeks of therapy, the drug combination of SSRI + PDE5i was the most effective PE therapy. In <8 weeks of therapy, the efficacy of local anaesthetics was best. All drug treatments were ranked better than placebo. In general, drugs with better effects had more obvious side effects.

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Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta‐analysis

et al. 2020

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Sexual Incentive Motivation and Copulatory Behavior in Male Rats Treated with the Adrenergic α2-Adrenoceptor Agonists Tasipimidine and Fadolmidine: Implications for Treatment of Premature Ejaculation

Lehtimäki

Ventura-Aquino²,

Chu

et al. 2021

The Journal of Sexual Medicine

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Background: Premature ejaculation is the most common sexual dysfunction in young men, and it often leads to reduced relationship satisfaction and quality of life.Aim: To determine the role of central and peripheral α2-adrenoceptors in the control of ejaculation and sexual incentive motivation in rats.Methods: Sexual incentive motivation was studied in a large arena in which a male subject could choose between approaching and remaining close to a sexually receptive female or another male.Sexual behavior was studied in standard observation cages in which a male was allowed to freely interact with a receptive female for 30 min. Two highly selective agonists at the α2-adrenoceptors, tasipimidine and fadolmidine, were administered before the tests. Low peripheral doses of fadolmidine has been reported to have effects mainly outside of the central nervous system, whereas at large doses also the central effects are evident. Outcomes:The time spent close to the receptive female in relation to the time spent with the male and measures of ambulatory activity were obtained from the test for sexual incentive motivation, while the habitual parameters of sexual behavior were recorded with the copulation test.Results: Tasipimidine prolonged ejaculation latency and the interintromission interval at the dose of 200 µg/kg when data from fast-ejaculating rats were used. No other sexual parameter was modified. A dose of 100 µg/kg was ineffective. There was no consistent effect on sexual incentive motivation, although modest sedation was observed. Fadolmidine, a drug that does not easily penetrate the blood-brain barrier, had no effect on sexual incentive motivation at any of the doses used (3, 30, and 100 µg/kg). The largest dose had clear sedative effects. The lower doses had no systematic effect on sexual behavior, not even when only fast or very fast ejaculating males were analyzed. Clinical Translation:The findings are relevant to the search for treatments for premature ejaculation that are specific enough to selectively delay ejaculation. Strengths & Limitations:The procedures used here are standard in the field and yield the most reliable data. Whether the effects observed in male rats are directly transferrable to men can only be determined through clinical studies. Conclusion:The observation that drugs acting at central but not peripheral α2-adrenoceptors prolong ejaculation latency without affecting any other parameter of sexual behavior or sexual incentive motivation suggests that this kind of drug may be suitable for treating premature ejaculation.

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Transcutaneous electric nerve stimulation to treat patients with premature ejaculation: phase II clinical trial

et al. 2019

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

Abstract: Supplemental Digital Content is available in the text

Cited by 7 publications

References 41 publications

Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta‐analysis

Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta‐analysis

Sexual Incentive Motivation and Copulatory Behavior in Male Rats Treated with the Adrenergic α2-Adrenoceptor Agonists Tasipimidine and Fadolmidine: Implications for Treatment of Premature Ejaculation

Transcutaneous electric nerve stimulation to treat patients with premature ejaculation: phase II clinical trial

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