Certain prescription medications, especiallyantidepressants that produce delayed
ejaculation as a side effect, may be useful as
therapeutic adjuncts. Recently, the use of a
class of drugs known as selective serotonin
receptor inhibitors (SSRIs) has shown
promise in the treatment of premature
ejaculation. The SSRIs prolong the time it
takes the man to ejaculate by as much as 30
minutes. The SSRIs most commonly used to
treat premature ejaculation are sertraline
(Zoloft), paroxetine (Paxil), clomipramine
(Anafranil) and fluoxetine (Prozac).
These prescription drugs are currently approved by the Food and Drug
Administration (FDA) for use in treating depression and panic attacks.
It is important to emphasize that the use of these drugs to treat
premature ejaculation is still considered experimental, as the FDA has
not approved them for this specific use as of 2002.
Treatment with SSRIs
Paroxetine(Paxil) was first shown to have a strong "ejaculation
delaying effect" in 1994, at dosages of between 20 and 40 mg per day.
Unfortunately, despite the claimed effectiveness, the drug companies
have not applied to the American FDA for approval for the use of the
drugs in this context. This may be because the drugs can in fact have
a major effect on sexual potency, and the drug companies do not wish
this fact to be highlighted.
However, when the published studies which are of a sufficiently high
standard on this matter are reviewed, the order of effectiveness of
these drugs is as follows:
Highest (most effective) - Paroxetine (20-40 mg)
Clomipramine (10-50 mg)
Sertraline(Zoloft) (50-100 mg)
Lowest (least effective) - Fluoxetine(Prozac) (20-40 mg)
Ejaculation delay apparently begins a few days after first taking
these drugs, but becomes most marked after a period of between one and
three weeks. The effect of delaying ejaculation is usually permanent,
but it may sometimes diminish after a year.
It should be noted that the mechanism by which these drugs delay
ejaculation is still unclear. Furthermore, there are a number of more
or less unpleasant side effects, which include fatigue, yawning, mild
nausea, loose bowels, sweating and so forth: these are claimed to
diminish with time, and to have mostly disappeared by three weeks into
the treatment regime. It is also claimed that loss of libido and
erectile function are reported by users of these drugs who seek to
extend their sexual performance and staying power. (This is not the
case with men who take them for depression.)
One unfortunate effect is priapism: that is to say, getting an
erection which lasts for hours. If this happens to you, please seek
urgent medical attention - any erection which lasts over three hours
can cause serious damage to the penis and its erectile mechanism.
Daily treatment with clomipramine:
There is a suggestion that use of 20-40mg clomipramine 3 to 5 hours
before sex can delay ejaculation - unfortunately, the side-effect is
nausea, which might be somewhat detrimental to the romance of the
occasion.
Immediate solution drug treatment for premature ejaculation
On demand drug treatment for prematureejaculation is obviously the desirable objective,
in that the drugs can be taken some time before
intercourse and ejaculation will later be delayed.
Some men with premature ejaculation may
benefit from drugs called phosphodiesterase
inhibitors, such as sildenafil (Viagra), vardenafil
(Levitra), and tadalafil (Cialis). A
phosphodiesterase inhibitor can be used alone or
in combination with an SSRI. One drug should be
started at a time, preferably at a low dose.
A review of the few studies that have been conducted suggest that
on-demand use of SSRIs do not have a significant impact on
ejaculation after 3-5 hours. There is another aspect to this too: the
spontaneity of sex is adversely affected when a drug has to be taken
several hours before sex (though those taking Viagra for erectile
problems may not agree that it is much of a disadvantage!)
The SSRI dapoxetine has been developed for on-demand treatment of
premature ejaculation but it has never been approved for the purpose.
Dapoxetine gets into the bloodstream quickly but it does not actually
produce much of a delay in the time between penetration and intercourse
- only a minute or two.
Tramadol is a centrally acting analgesic agent that combines opioid
receptor activation and inhibits uptake of serotonin and noradrenaline.
It can produce a delay in ejaculation, but it has unpleasant side-effects
in 28% of men including nausea and vomiting.
Precautions - Common Side Effects of Prescription Drugs for
Premature Ejaculation:
Caution in recent MI or unstable heart disease; hyponatremia; although
minimal adverse anticholinergic effects (compared with TCAs), use with
caution in glaucoma, bladder outlet obstruction, chronic constipation, a
nd other conditions in which adverse anticholinergic effects may exacerbate
symptoms; also caution in moderate-to-severe renal or hepatic impairment,
because of excessive blood level accumulation (adjust dose accordingly);
Any drug affecting the central nervous system may cause drowsiness, and
driving and performance of other tasks requiring alertness and concentration
should be avoided; seizures are rare; caution in preexisting seizure
disorder; when used for premature ejaculation (off-label), patients with
clinical depression should be treated by a mental health care professional;
skin with rash, skin eruption, or other skin irritation.
Potential for depressed patients to commit suicide; priapism has been
(rarely) reported, stroke, or life-threatening arrhythmia within last 6
months; with resting hypotension (BP <> 170/110); unstable angina
due to cardiac failure or CAD; anatomical penile deformation;
predisposition to priapism; and retinitis pigmentosa; avoid in men where
sexual activity is inadvisable due to underlying cardiovascular status.
That's it for now! Until next time, Make the rest of your day great.
Your friend in success,
Robert
The Penis Help Center
P.S. No man has to suffer the disappointment and emotional effects of
premature ejaculation. Premature ejaculation can easily be corrected, safely
and naturally, Click to learn how to stop your premature ejaculation!
P.P.S. Here are links to some of our Top Rated Associates' websites, you
may find them useful in your pursuit to be the best man you can be:
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