The selective serotonin re-uptake inhibitors fluvoxamine and paroxetine differ in sexual inhibitory effects after chronic treatment

Waldinger, Marcel D.; Plas, Afke van de; Pattij, Tommy; Oorschot, Ruud van; Coolen, Lique M.; Veening, Jan G.; Olivier, Berend

doi:10.1007/s00213-001-0980-3

Cited by 71 publications

(44 citation statements)

References 30 publications

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“…This development seems to coincide with a specific interest to perform clinical and basic research on the mechanisms driving premature ejaculation, for example, a tendency to focus on the sensory input of tactile stimuli (eg sensitivity of the glans penis and evoked potentials of peripheral neurons) in the far East, 91,92 in contrast, a tendency to focus on the motoric output (eg serotonergic brain and spinal cord areas) in Western countries. 4,5,93 It is of relevance to note that, in studies on ointments in the Far East, a 3 min criterion seems in use, in contrast to the 1-2 min inclusion criterion in drug treatments in Western countries.…”

Section: Pharmacological Considerationsmentioning

confidence: 99%

“…[1][2][3] Based on animal 4 and human psychopharmacological studies, Waldinger et al have postulated that lifelong premature ejaculation is a neurobiological phenomenon related to decreased central serotonergic neurotransmission, 5-HT 2C receptor hyposensitivity and/or 5-HT 1A hypersensitivity. [5][6][7] In addition, Waldinger postulates that lifelong early ejaculation is not an acquired disorder due to learned behavior, as has been suggested by Masters and Johnson, but, instead, belongs to the normal biological variability of the intravaginal ejaculation latency time (IELT) in men, with a possible familial genetic vulnerability.…”

Section: Introductionmentioning

confidence: 99%

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Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies (3034 males), published between 1943 and 2003, are reviewed. A meta-analysis is performed on 43 selective serotonin reuptake inhibitors (SSRIs) and clomipramine studies (1514 males), published between 1973 and 2003; these studies were pooled to provide a summary variance-weighted effect size. The antidepressant-induced percentage increase of the intravaginal ejaculation latency time (IELT) was calculated and examined against various methodological items. A significant difference in efficacy between SSRIs was observed. Using daily treatment, paroxetine appeared more effective than the other SSRIs. Retrospective use of a questionnaire, subjective reports, single-blind and open study designs generate far greater variability of ejaculation time both at baseline and during active drug treatment than real time assessment by stopwatch. In conclusion, at daily treatment, the overall efficacy of paroxetine, clomipramine, sertraline and fluoxetine is comparable, but paroxetine exerts the strongest ejaculation delay. Only eight (18.5%) studies on antidepressant treatment fulfilled all criteria used in evidence-based medicine, for example, randomised, double-blind studies with prospective real time (stopwatch) assessment of the IELT at each intercourse. Single-blind studies, open designs, retrospective reporting, or the use of a questionnaire to assess ejaculation time should be avoided.

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Section: Pharmacological Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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“…19 The extent of such delay depends on the type, dosage and frequency of SSRI administration. Other SSRIs, specifically fluvoxamine 28 and venlafaxine, 29 have not proven useful for delaying ejaculation. Although none of these agents has been approved for treating PE, the current American Urological Association guidelines 30 and the recommendations of the International Consultation on Sexual Dysfunction 31 suggest the off-label use of SSRIs for managing PE.…”

Section: Antidepressive Agentsmentioning

confidence: 99%

“…24 Some studies have evaluated the use of SSRI antidepressants and 'as needed' dosing, but the study designs were not rigorous. 28,77 In recent years, however, several pharmaceutical companies have become interested in on-demand treatment of PE with SSRIs that have a short half-life and a very short period to attain maximum concentration. An example of such a drug is dapoxetine.…”

Section: On-demand Therapy Of Ssrismentioning

confidence: 99%

Current therapeutic strategies for premature ejaculation and future perspectives

Xin¹,

Zhu²,

Yuan³

et al. 2011

Asian J Androl

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Premature ejaculation (PE) is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used 'off-label', some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE. Ejaculation is a tightly coordinated activity with different ejaculatory organs and a spinal reflex initiated by genital and/or brain stimulation through the peripheral sensory receptors and regions, afferent pathways, the central nervous system ejaculatory centre of the brain (namely, sensory and motor areas located in the para-ventricular nucleus of the hypothalamus and the medial preoptic area). The spinal ejaculatory centre, located at the T 12 -L 1-2 spinal cord level (paragigantocellular), and its efferent pathway modulate the function of the ejaculatory organs. Ejaculation is also mediated by a complex interaction of central serotonergic and dopaminergic neurons with the secondary involvement of cholinergic, adrenergic, oxytocinergic and GABAergic neurons.Ejaculation consists of two main phases, the emission phase and the expulsion phase. The emissions include seminal fluid and secretions of the prostate and bulbourethral glands. In this phase, the contraction of accessory ejaculatory organs induces the accumulation of semen in the posterior urethra. Expansion of the posterior urethra creates a feeling of emission and sensory information that is transmitted to the spine via dorsal nerve sensory pathway and along the spinal cord up to the brain ejaculatory centre during the sexual arousal phase. The expulsion phase consists of the highly regular rhythmic contraction of striated muscles and the relaxation of smooth muscles in the ejaculatory ducts. The ejaculated semen can be divided into a number of components by serial biochemical analysis. 1 These include secretions from the seminal vesicles, prostate and bulbourethral (Cowper's) glands and spermatozoa.

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“…In addition, serotonin and dopamine also play a role in male sexual behavior. A single intraperitoneal injection of the 5-HT 1A receptoragonist 8-hydroxy-2-(di-n-propylaminotetralin) (8-OH-DPAT) induces an almost instantaneous ejaculation in the male rat (Ahlenius et al, 1981;Coolen et al, 1997b), while administration of selective serotonin reuptake inhibitors may induce a delayed ejaculation, particularly after chronic administration (Mos et al, 1999;Waldinger et al, 2002). Selective serotonin reuptake inhibitors are clinically applied successfully for treatment of premature ejaculation (Waldinger et al, 2003(Waldinger et al, , 1998.…”

Section: Introductionmentioning

confidence: 99%

Effects of acute and chronic apomorphine on sex behavior and copulation-induced neural activation in the male rat

Olivier

Jong

Dederen

et al. 2007

European Journal of Pharmacology

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Apomorphine is a non-selective dopaminergic receptor agonist. Because of its pro-erectile effects, apomorphine is clinically used for treatment of erectile dysfunction. We investigated the effects of subcutaneous apomorphine administration (0.4 mg/kg rat) on sexual behavior and matinginduced Fos-expression following acute (day 1) or chronic apomorphine treatment (days 8 and 15) in sexually experienced male rats. Consistent facilitatory effects of apomorphine were observed in the reduced numbers of mounts and intromissions over time and an increased ejaculation frequency on day 1. The first post-ejaculatory interval, however, was lengthened, while other behavioral parameters were unaffected. Fosimmunoreactivity induced by acute apomorphine administration (barrel cortex, paraventricular hypothalamic nucleus, central amygdala and locus coeruleus) was strongly reduced after chronic administration. After mating, induction of Fos-immunoreactivity was observed in well-known areas like medial preoptic nucleus and the posterodorsal medial amygdaloid area. Apomorphine, however, reduced mating-induced Fosimmunoreactivity in the nucleus accumbens shell and prevented its occurrence in its core area. This remarkable apomorphine effect was not observed in any other brain area. We conclude that the behavioral (pro-erectile) effects of apomorphine are consistent over time, and that the diminished accumbens-Fos-immunoreactivity and the elongated post-ejaculatory interval may reflect a decreased response to remote cues from the estrus female.

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The selective serotonin re-uptake inhibitors fluvoxamine and paroxetine differ in sexual inhibitory effects after chronic treatment

Cited by 71 publications

References 30 publications

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Current therapeutic strategies for premature ejaculation and future perspectives

Effects of acute and chronic apomorphine on sex behavior and copulation-induced neural activation in the male rat

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