Premature ejaculation, treatment of the premature ejaculation and efficacy of selective serotonin reuptake inhibitors in the treatment of premature ejaculation

摘要

Some selective serotonin reuptake inhibitors (SSRIs) have increasingly become the first choice for the treatment of premature ejaculation. However, SSRIs have been reported to affect several aspects of sexual function, including libido, sexual arousal, time to reach orgasm, and orgasm quality. This paper focuses on the efficacy, side effects and dosage schedules of SSRIs in the treatment of premature ejaculation. We found that studies of the use of SSRIs in the treatment of premature ejaculation have been increased after 1990. We have searched Medline, Pubmed, Ovid and Türk Psikiyatri Dizini data bases between 1990 and 2005. The goal of this paper is to contribute to every day psychiatric practice. As pharmacotherapies, paroxetine, sertraline, and ?uoxetine seem efficient in the treatment of premature ejaculation, but ?uvoxamine is not. There is no agreement on the efficacy of citalopram. Paroxetine seems to be the most effective among the SSRIs in the treatment of premature ejaculation. On the other hand, it has the most powerfull side effects. New and potent serotonin transport inhibitors with a short half-life may be advantageous for the treatment of premature ejaculation where an acute effect to delay ejaculation followed by a relatively rapid fall in SSRI plasma concentration might be desirable. However, the side effects, maintenance therapy and spontaneous loss of efficacy are still unresolved issues.