Dapoxetine shows promise as a treatment for premature ejaculation.
Because delayed ejaculation is one side effect of selective serotonin reuptake inhibitors (SSRIs), they are sometimes used off-label to treat premature ejaculation. However, long-acting SSRIs require chronic dosing, which can cause other side effects, including decreased libido and erectile dysfunction. Dapoxetine is a short-acting SSRI (time to peak concentration, 1 hour) developed specifically for on-demand treatment of premature ejaculation.
In two 12-week manufacturer-sponsored randomized trials, 2600 men (mean age, 40; 87% white) with self-reported moderate-to-severe premature ejaculation (average duration, 16 years) took dapoxetine (30 mg or 60 mg) or placebo 1 to 3 hours before anticipated sexual intercourse. All subjects had steady female sexual partners and intravaginal ejaculatory latency time (IELT) of 2 minutes or shorter (measured by their partners with stopwatches).
At baseline, mean IELT was about 0.9 minutes. After the first dose, mean IELT increased in the placebo, low-dose, and high-dose dapoxetine groups to 1.4, 2.1, and 2.4 minutes, respectively. At 12 weeks, mean IELTs were 1.8, 2.8, and 3.3 minutes, respectively, and 14%, 29%, and 34% of men in the respective groups had IELTs longer than 3 minutes. All differences between dapoxetine and placebo were statistically significant. Patients’ perception of control over ejaculation and patients’ and partners’ satisfaction with intercourse also improved significantly. Side effects included nausea, diarrhea, headache, and dizziness, but few participants discontinued therapy.
Comment: Dapoxetine appears to be a promising treatment for premature ejaculation, at least in men who are similar to those enrolled in this study. Dapoxetine is not yet FDA-approved for this indication.
— Bruce Soloway, MD
Published in Journal Watch October 5, 2006
Citation(s):
Pryor JL et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: An integrated analysis of two double-blind, randomised controlled trials. Lancet 2006 Sep 9; 368:929-37.