Abstract
Purpose
In the current analysis due to the mechanism of effect, we evaluated the treatment benefit of duloxetine 40 mg comparing with paroxetine 20 mg, based on its effects on personal distress and interpersonal difficulty related to ejaculation, perceived control over ejaculation, and satisfaction with sexual intercourse, as well as the patient-reported global impression of change in premature ejaculation (PE) and the effect on intravaginal ejaculatory latency times (IELT) in men with premature ejaculation.
Materials and methods
The study included 80 married male patients diagnosed with lifelong PE. A total of 80 patients were randomly distributed into two groups of 40 patients each. Group 1 patients received 40 mg duloxetine once a day for a month. Group 2 patients received 20 mg paroxetine once a day for a month. International index of erectile function questionnaire (IIEF) and IELT and PE profile were recorded before and after treatment.
Results
Comparing the groups’ mean treatment IELT, there was no difference between groups. The IELT increase from baseline to treatment was 117 % in the duloxetine group (P < 0.001) and 126 % in the paroxetine group (P < 0.001). There was no statistical difference between two groups in terms of IELT increase (P > 0.05). Also, there was no statistically significant difference between two groups at baseline IIEF to treatment IIEF scores. All PEP measures improved significantly with duloxetine and paroxetine groups (P < 0.001).
Conclusion
We think that duloxetine is safe and effective for the treatment for premature ejaculation.
Similar content being viewed by others
References
Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J (2007) The premature ejaculation prevalence and attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol 51:816–824
Vale J (1999) Ejaculatory dysfunction. BJU Int 83:557
Polat EC, Ozbek E, Otunctemur A, Ozcan L, Simsek A (2014) Combination therapy with selective serotonin reuptake inhibitors and phosphodiesterase-5 inhibitors in the treatment of premature ejaculation. Andrologia. May 9
Balon R (1996) Antidepressants in the treatment of premature ejaculation. J Sex Marital Ther 22:85–96
Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B (2004) Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 16:369–381
Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R, Miloslavsky M, Kell S (2006) Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomized controlled trials. Lancet 368:929–937
Porst H, McMahon CG, Althof SE, Sharlip I, Bull S, Aquilina JW, Tesfaye F, Rivas DA (2010) Baseline characteristics and treatment outcomes for men with acquired or lifelong premature ejaculation with mild or no erectile dysfunction: integrated analyses of two phase 3 dapoxetine trials. J Sex Med 7:2231–2242
Wong DT, Bymaster FP, Mayle DA et al (1993) LY248686, a new inhibitor of serotonin and norepinephrine uptake. Neuropsychopharmacology 8(1):23–33
Athanasios Z, Polyanthi P, George K (2007) The efficacy of duloxetine in the treatment of premature ejaculation. Int Urol Nephrol 39:115–118
Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B (1998) Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. J Clin Psychopharmacol 18:274–281
Waldinger M, Berendsen H, Blok B, Olivier B, Holstege G (1998) Premature ejaculation and serotonergic antidepressants induced delay induced delayed ejaculation: the involvement of the serotonergic system. Behav Brain Res 92:111–118
Waldinger MD (2002) The neurobiological approach to premature ejaculation. J Urol 168:2359–2367
Waldinger MD, Hengeveld MW, Zwinderman AH (1994) Paroxetine treatment of premature ejaculation: a doubleblind, randomised, placebo-controlled study. Am J Psychiatry 151:1377–1379
McMahon CG, Touma K (1999) Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single blind placebo controlled crossover studies. J Urol 161:1826
Basu M, Duckett JR (2009) Update on duloxetine for the management of stress urinary incontinence. Clin Interv Aging 4:25–30
Detke M, Lu Y, Goldstein D et al (2002) Duloxetine 60 mg once daily for major depressive disorder: a randomised double-blind placebo controlled trial. J Clin Psychiatry 63:308–315
Goldstein D, Mallinckrodt C, Lu Y, Demitrack M (2002) Duloxetine in the treatment of major depressive disorder: a double blind clinical trial. J Clin Psychiatry 63:225–231
Raskin J, Goldstein D, Mallinckrodt C, Ferguson M (2003) Duloxetine in the long term treatment of major depressive disorder. J Clin Psychiatry 64:1237–1244
Patrick DL, Rowland D, Rothman M (2007) Interrelationships among measures of premature ejaculation: the central role of perceived control. J Sex Med 4(3):780–788
Giuliano F, Patrick DL, Porst H et al (2008) Premature ejaculation: results from a five-country European observational study. Eur Urol 53(5):1048–1057
Grenier G, Byers ES (2001) Operationalizing premature or rapid ejaculation. J Sex Res 38:369–378
Grenier G, Byers ES (1997) The relationships among ejaculatory control, ejaculatory latency, and attempts to prolong heterosexual intercourse. Arch Sex Behav 26:27–47
Kaufman JM, Rosen RC, Mudumbi RV, Tesfaye F, Hashmonay R, Rivas D (2009) BJU Int 103(5):651–658
McCormack PL, Keating GM (2004) Duloxetine: in stress urinary incontinence. Drugs 64(22):2567–2573
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozcan, L., Polat, E.C., Otunctemur, A. et al. Duloxetine, dual serotonin and norepinephrine reuptake inhibitor, versus paroxetine, selective serotonin reuptake inhibitor, in the treatment for premature ejaculation. Int Urol Nephrol 47, 283–287 (2015). https://doi.org/10.1007/s11255-014-0905-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-014-0905-9