Evidence Based Medicine on the Pharmacologic Management of Premature Ejaculation (Pages: 0-0)

Mohammad RezaSafarinejad *,


Objective: To evaluate the efficacy and safety of most popular selective serotonin reuptake inhibitors (SSRIs) drug (citalopram escitalopram dapoxetine paroxetine venlafaxine) and tramadol and pindolol in delaying ejaculation in patients with premature ejaculation (PE). Materials and Methods: A predetermined number of married men with PE were randomly assigned to receive the study drug or placebo. Pretreatment evaluation included history and physical examination intravaginal ejaculatory latency time (IELT) International Index of Erectile Function (IIEF) and Meares-Stamey test. The efficacy of each treatment was assessed every 2 weeks during treatment at the end of study using responses to IIEF IELT evaluation mean intercourse satisfaction domain mean weekly coitus episodes and adverse drug effects. Results: The IELT after citalopram and placebo gradually increased from 32 and 28 seconds to approximately 268 and 38 seconds respectively. The mean IELT after dapoxetine and placebo increased from 28 and 31 seconds to approximately 193 and 54 seconds respectively (P =0.001). At the end of trial with dapoxetine paroxetine and placebo the mean IELT was increased from 38 31 and 34 seconds to 179 370 and 55 seconds respectively. The mean IELT increased from 31 and 29 seconds to 516 and 54 seconds with escitalopram and placebo respectively (P=0.001). The geometric mean IELT in paroxetine-pindolol and paroxetine-placebo group demonstrated 3.7 (95% confidence interval (CI): 2.16-5.26) and 1.7 (95% CI: 0.82-1.81) fold-increase respectively (P=0.001). The mean IELT after tramadol and placebo increased from 19 and 21 seconds to approximately 243 and 34 seconds respectively ( P