TREATMENT OF PREMATURE EJACULATION WITH PAROXETINE HYDROCHLORIDE AS NEEDED: 2 SINGLE-BLIND PLACEBO CONTROLLED CROSSOVER STUDIES

No AccessJournal of UrologyClinical Urology: Original Articles1 Jun 1999TREATMENT OF PREMATURE EJACULATION WITH PAROXETINE HYDROCHLORIDE AS NEEDED: 2 SINGLE-BLIND PLACEBO CONTROLLED CROSSOVER STUDIES CHRIS G. McMAHON and KAMAL TOUMA CHRIS G. McMAHONCHRIS G. McMAHON and KAMAL TOUMAKAMAL TOUMA View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68816-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the efficacy of paroxetine hydrochloride as needed for the treatment of premature ejaculation. Materials and Method: Study 1 comprised 26 potent men with a mean age of 39.5 years with premature ejaculation who were randomized to receive 20 mg. oral paroxetine (group A) or placebo (group B) as needed 3 to 4 hours before planned intercourse in a controlled single-blind crossover trial. Study 2 comprised 42 potent men with a mean age of 40.5 years with premature ejaculation who were randomized to receive 10 mg. paroxetine daily for 3 weeks and then 20 mg. paroxetine as needed (group C) for 4 weeks or placebo daily for 3 weeks and then placebo as needed (group D) for 4 weeks. Results: Mean pretreatment ejaculatory latency time was 0.3 minute for study 1. At 4 weeks mean ejaculatory latency time was 3.2 minutes in the paroxetine as needed and 0.45 in the placebo as needed phase for group A (p <0.001), and 0.6 in the placebo as needed and 3.5 in the paroxetine as needed phase for group B (p <0.001). There were no adverse effects with paroxetine or placebo in study 1. Mean pretreatment ejaculatory latency time was 0.5 minute for study 2. At 3 weeks mean ejaculatory latency time was 4.3 minutes in the paroxetine daily and 5.8 in the paroxetine as needed phase, and 0.9 in the placebo daily and 0.6 in the placebo as needed phase for group C (p <0.001). At 3 weeks mean ejaculatory latency time was 0.8 minutes in the placebo daily and 1.1 in the placebo as needed phase, and 3.3 in the paroxetine daily and 6.1 in the paroxetine as needed phase for group D (p <0.001). Adverse effects in 7 of 42 men (17%) given paroxetine daily included anejaculation in 3, anorexia in 1, gastrointestinal upset in 3 and reduced libido in 2. Mean ejaculatory latency time was greater in the paroxetine as needed phase of study 2 than that of study 1 (p <0.05). suggesting that ejaculatory control achieved with paroxetine as needed is significantly better if patients are initially treated with the drug daily. Conclusions: Paroxetine appears to be superior to placebo in the pharmacological treatment of premature ejaculation when administered on a chronic or as needed basis. References 1 . Washington, D. C.: American Psychiatric Association1994: 509. Google Scholar 2 : Brain monoaminergic control of male reproductive behaviour. II. Dopamine and the post-ejaculatory refractory period. Behav. Brain Res.1984; 12: 267. Google Scholar 3 : Preliminary results from a multicenter trial of chlomipramine in obsessive-compulsive disorder. Psychopharmacol. Bull.1989; 25: 36. Google Scholar 4 : Anorgasmia from chlomipramine in obsessive-compulsive disorder: a controlled trial. Brit. J. Psychiat.1987; 151: 107. Crossref, Medline, Google Scholar 5 : A double blind trial of chlomipramine in premature ejaculation. Andrologia1982; 14: 364. Crossref, Medline, Google Scholar 6 : The role of chlomipramine in the treatment of premature ejaculations. J. Urol.1994; 151: 345A. abstract 470. Google Scholar 7 : An assessment of chlomipramine (Anafranil) in the treatment of premature ejaculation. J. Int. Med. Res.1980; 3: 53. Google Scholar 8 : Fluoxetine induced sexual dysfunction (Letter to the Editor). J. Clin. Psychiat.1993; 54: 71. Google Scholar 9 : The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J. Urol.1996; 156: 1631. Link, Google Scholar 10 Crenshaw, R.: Treatment of premature ejaculation with fluoxetine. Presented at American Psychiatric Association Meeting, May 1992. Google Scholar 11 : Fluoxetine for premature ejaculation. Amer. J. Psychiat.1994; 151: 1523. Crossref, Medline, Google Scholar 12 : Sertraline hydrochloride for premature ejaculation. J. Urol.1994; 151: 345A. abstract 471. Google Scholar 13 : Sertraline treatment for premature ejaculation. J. Clin. Psychopharmacol.1995; 15: 341. Crossref, Medline, Google Scholar 14 : Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study. J. Urol.1998; 159: 1935. Link, Google Scholar 15 : Paroxetine treatment of premature ejaculation: a double-blind randomized, placebo-controlled study. Amer. J. Psychiat.1994; 151: 1377. Crossref, Medline, Google Scholar 16 : Ejaculation-retarding properties of paroxetine in men with primary premature ejaculation: a double-blind, randomized, dose-response study. Brit. J. Urol.1997; 79: 592. Google Scholar 17 : Paroxetine in the treatment of premature ejaculation. Brit. J. Urol.1996; 77: 881. Crossref, Medline, Google Scholar 18 : Paroxetine in the treatment of premature ejaculation. Arch. Ital. Urol. Androl.1997; 69: 11. Google Scholar 19 McMahon, C.G.: Treatment of premature ejaculation with paroxetine hydrochloride. Int. J. Impotence Res., suppl., 9: S38, abstract 36. Google Scholar 20 : Paroxetine: pharmacokinetics and pharmacodynamics. Fortschritte der Neurologie-Psychiatrie1994; 62: 2. Google Scholar 21 : The role of cytochrome P450 2D6 in the metabolism of paroxetine by human liver microsomes. Brit. J. Clin. Pharmacol.1992; 33: 531. Google Scholar 22 : Pharmacokinetics of anti-depressants: why and how they are relevant to treatment. J. Clin. Psychiat.1993; 54: 14. Google Scholar 23 : A review of the metabolism and pharmacokinetics of paroxetine in man. Acta Psychiat. Scand.1991; 80: 60. Google Scholar From St. Luke's Hospital Complex, Sydney, Australia© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byShindel A, Althof S, Carrier S, Chou R, McMahon C, Mulhall J, Paduch D, Pastuszak A, Rowland D, Tapscott A and Sharlip I (2021) Disorders of Ejaculation: An AUA/SMSNA GuidelineJournal of Urology, VOL. 207, NO. 3, (504-512), Online publication date: 1-Mar-2022.Giuliano F, Bernabé J, Gengo P, Alexandre L and Clément P (2018) Effect of Acute Dapoxetine Administration on the Pudendal Motoneuron Reflex in Anesthetized Rats: Comparison With ParoxetineJournal of Urology, VOL. 177, NO. 1, (386-389), Online publication date: 1-Jan-2007.Motofei I (2018) RE: The Neurobiological Approach to Premature EjaculationJournal of Urology, VOL. 170, NO. 3, (929-929), Online publication date: 1-Sep-2003.SALONIA A, MAGA T, COLOMBO R, SCATTONI V, BRIGANTI A, CESTARI A, GUAZZONI G, RIGATTI P and MONTORSI F (2018) A Prospective Study Comparing Paroxetine Alone Versus Paroxetine Plus Sildenafil in Patients With Premature EjaculationJournal of Urology, VOL. 168, NO. 6, (2486-2489), Online publication date: 1-Dec-2002.WALDINGER M (2018) The Neurobiological Approach to Premature EjaculationJournal of Urology, VOL. 168, NO. 6, (2359-2367), Online publication date: 1-Dec-2002. Volume 161Issue 6June 1999Page: 1826-1830 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information CHRIS G. McMAHON More articles by this author KAMAL TOUMA More articles by this author Expand All Advertisement PDF downloadLoading ...