Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double‐blind, placebo‐controlled study On-demand tramadol hydrochloride use in premature ejaculation treatment. Topical eutectic mixture for premature ejaculation (TEMPE): a novel aerosol‐delivery form of lidocaine‐prilocaine for treating premature ejaculation Treatment benefit of dapoxetine for premature ejaculation: results from a placebo‐controlled phase III trial Sertraline in the treatment of premature ejaculation: A double-blind placebo controlled study Can sildenafil treat primary premature ejaculation? A prospective clinical study. The efficacy of duloxetine in the treatment of premature ejaculation The Efficacy and Safety of On-demand Tramadol and Paroxetine Use in Treatment of Life Long Premature Ejaculation: A Randomized Double-blind Placebo-controlled Clinical Trial Comparison Between Tadalafil Plus Paroxetine and Paroxetine Alone in the Treatment of Premature Ejaculation Effect of Fluoxetine Alone and in Combination with Sildenafil in Patients with Premature Ejaculation Improved ejaculatory latency, control and sexual satisfaction when PSD502 is applied topically in men with premature ejaculation: results of a phase III, double-blind, placebo-controlled study. Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study Paroxetine treatment of premature ejaculation: a double-blind, randomized, placebo-controlled study. Safety and Efficacy of Escitalopram in the Treatment of Premature Ejaculation: A Double-Blind, Placebo-Controlled, Fixed-Dose, Randomized Study Treatment of premature ejaculation in the Asia-Pacific region: results from a phase III double-blind, parallel-group study of dapoxetine. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study.
To assess the use of a topical anaesthetic mixture to improve  premature ejaculation ( PE )  , for which penile hypersensitivity might be a cause To determine the effect of PSD502 applied topically 5 min before intercourse on the Index of Premature Ejaculation ( IPE ) and intravaginal ejaculatory latency time ( IELT ) of men with lifelong premature ejaculation ( PE ) defined according to the International Society of Sexual Medicine ( ISSM ) definition ; secondary objectives were to evaluate the safety and tolerability of PSD502 in patients with PE , and their sexual partners OBJECTIVES To determine the efficacy of tramadol in premature ejaculation ( PE ) treatment compared with placebo . METHODS A single-blind , placebo-controlled , crossover study was conducted with 60 lifelong ( primary ) patients with PE . The patients were r and omized into 2 groups , each consisting of 30 patients , who took tramadol or placebo on dem and . PE was defined as an intravaginal ejaculation latency time of ≤60 seconds in 90 % of intercourse episodes . The efficacy of the drugs was assessed using the intravaginal ejaculation latency time , ability of ejaculation control , and sexual satisfaction scores after an 8-week treatment period . RESULTS All participants completed the study voluntarily . Two groups were similar in terms of the patient demographics . Increases in the intravaginal ejaculation latency time , ability of ejaculation control , and sexual satisfaction score between the placebo and tramadol groups were compared with the baseline values in both groups . At the end of study period , the tramadol group had significantly ( P<.001 ) greater values for all 3 parameters compared with those in the placebo group . CONCLUSIONS On-dem and use of low-dose tramadol is effective for lifelong PE . Currently , selective seratonin reuptake inhibitors such as dapoxetine , are a more popular treatment option for PE . However , tramadol might be considered an alternative agent for primary PE treatment To evaluate , in a phase II study , the efficacy and safety of a topical eutectic mixture for premature ejaculation ( TEMPE ) , a metered‐dose aerosol spray containing a eutectic mixture of lidocaine and prilocaine , as a treatment for PE To evaluate the overall treatment benefit of dapoxetine for  premature ejaculation ( PE )  , with specific emphasis on improvements in personal distress and interpersonal difficulty related to ejaculation .  Although these factors are key elements of numerous sets of diagnostic criteria for PE , they have rarely been evaluated as outcome measures in clinical trials This study investigated the efficacy and the adverse effects of sertraline in the treatment of premature ejaculation ( PE ) . Thirty-seven patients with PE were r and omly assigned to receive either sertraline or a placebo . Of them 22 were given 50 mg of sertraline per day and the other 15 patients were given an identical placebo one per day . After 4 weeks , the latency to ejaculation in the sertraline group was found to be significantly longer than that of the placebo group ( p<0.01 ) . None of the patients discontinued therapy due to adverse effects . These results indicate that  sertraline is an effective therapy for PE BACKGROUND Recently , sildenafil has been demonstrated to be effective in treating  premature ejaculation ( PE ) .  However , these studies ignored female factors and could not exclude the probability of drug interaction when combined with paroxetine . Therefore , the aim of this study was to evaluate the efficacy and safety of sildenafil alone in the treatment of primary PE , taking female factors into consideration . METHODS One hundred and eighty potent men with primary PE were r and omly divided into three groups and followed up for 6 months . Group A were treated with 50 mg sildenafil as needed , group B with 20 mg paroxetine daily and group C with squeeze technique daily .  Intravaginal ejaculatory latency time ( IELT ) , PE grade , intercourse satisfactory score ( ISS ) , frequency of intercourse , and adverse effects of drugs were recorded before treatment , and 3 and 6 months after treatment . RESULTS Compared with pretreatment , the three groups had significant differences in all the parameters after 3 or 6 months treatment , except the frequency of intercourse in Group C ( all P = 0.00 ) . However , there were no significant differences between 3 and 6 months . Compared with paroxetine and squeeze technique , after 3 or 6 months , sildenafil had significant differences in all the parameters ( all P = 0.00 ) . After 6 months , 1.7 % , 18.3 % and 36.7 % patients in groups A , B and C , respectively , withdrew from the study and 86.7 % , 60.0 % and 45.0 % patients , respectively , wanted to be treated further with the original administration , and this was statistically significant ( both P = 0.00 ) . CONCLUSION Sildenafil is very effective and safe to treat PE , and has much higher efficacy than paroxetine and squeeze technique Abstract Aim : Though premature ejaculation ( PE ) has been overshadowed by current attention given to erectile dysfunction , it is the most widespread form of male sexual dysfunction . Delayed or inhibited ejaculation , a known side effect of selective serotonin reuptake inhibitors ( SSRIs ) , has made SSRIs potentially useful in the treatment of this disorder . In the present study , we examined the efficacy of duloxetine , an SSRI , in the treatment of PE . Method : The study included 20 married patients diagnosed with PE . The patients were r and omly assigned to two groups , duloxetine ( group I ) and placebo ( group II ) , each consisting of 10 patients . The effects on the ejaculatory function were estimated by the intravaginal ejaculation latency time . All patients were evaluated by using clinical global impression-improvement Scale ( CGI-I ) . Results : The increase in the intravaginal ejaculation latency time in the duloxetine group was statistically significant than that of placebo group . Of group I patients , four ( 40 % ) were considered as “ very much improved ” and four ( 40 % ) “ much improved ” by CGI-I and only one of group II patients ( 10 % ) showed “ much improved ” . Conclusion : Duloxetine appears to be superior to placebo in the pharmacological treatment of PE when administered on a chronic basis Background : Several medical therapies have been proposed for the treatment of  premature ejaculation ( PE ) .  Paroxetine and tramadol were both reported to be effective in treatment of PE . In this study , the therapeutic effects of tramadol , paroxetine and placebo were compared in treatment of primary PE . Methods : In this r and omized , double-blind , placebo-controlled clinical trial , 150 patients were divided into 3 groups . One group was treated with tramadol 50 mg ondem and , the other group took paroxetine 20 mg on-dem and and the third group was treated with placebo . Before starting treatment and after 12 weeks , patients were asked to measure their average intravaginal ejaculation latency time ( IELT ) and fill the PEP ( Premature Ejaculation Profile ) question naire . Results : At the end of the 12th week , the mean IELT and average of PEP scores improved in all 3 groups . The increase in tramadol group was significantly higher than the paroxetine and placebo groups ( p<0.0001 ) . There were no significant differences in terms of side effects between the 3 groups . Conclusion : The results showed that despite an increase in mean IELT and PEP scores in all 3 groups , the rate of improvement in tramadol group was significantly more than the others . Thus , tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE Background : Several recent studies have investigated the therapeutic role of phosphodiesterase type 5 ( PDE5 ) inhibitors in premature ejaculation ( PE ) used in the treatment of erectile dysfunction . Objectives : In the present research , the efficacy of paroxetine alone and paroxetine plus tadalafil was compared in patients referred because of premature ejaculation . Patients and Methods : This quasi-experimental study was performed on 100 consecutive 17 to 49-year-old potent men with premature ejaculation and without any clear organic disease . All patients had lifelong PE with an intravaginal ejaculation latency time ( IELT ) shorter than 1.5 minutes . Informed consent was obtained from all patients who were r and omly divided into two groups using a computer-generated r and om tabulation list . In group A , patients received 10 mg paroxetine daily , in addition to four hours before planned sexual activity . In group B , 10 mg paroxetine was taken daily , plus 10 mg tadalafil one hour before planned sexual activity . The duration of the intervention was six months and patients were evaluated for IELT three and six months after the beginning of therapy . Results : The mean age of patients in groups A and B were 33 ± 9.6 and 31.2 ± 9.3 years , respectively ( P = 0.368 ) . The mean number of intercourses were 1.08 ± 0.6 and 1.12 ± 0.6 per week in groups A and B , respectively ( P = 0.791 ) . Mean IELT at the 3-month follow up in groups A and B was 4.5 ± 1.5 and 5 ± 2.4 minutes , respectively ( P = 0.285 ) and at the 6-month follow up was 4.8 ± 1 and 5.3 ± 2 minutes , respectively ( P = 0.278 ) . Conclusions : The results of the study show that tadalafil can increase the mean IELT and can be used for treatment of premature ejaculation in combination with paroxetine Introduction : The aim of this study was to compare the efficacy of fluoxetine alone and combined with sildenafil in patients complaining of premature ejaculation . Patients and Methods : Ninety-one married potent men , 21–43 years old , with premature ejaculation but without any obvious organic cause were enrolled . Pretreatment evaluation included history , physical examination , and self-administration of the International Index of Erectile Function question naire . The patients were r and omly divided into two groups : group A patients ( n = 48 ) received 20 mg fluoxetine daily for 4 weeks and then 20 mg as needed 2–3 h before sexual activity for 4 months , and group B patients ( n = 43 ) received group A regimen plus 50 mg sildenafil as needed 1 h before sexual activity for 4 months . Results : Ejaculatory latency time and intercourse satisfaction significantly improved in group B as compared with group A ( p < 0.05 ) . Conclusion : Fluoxetine combined with sildenafil seems to provide significantly better ejaculatory latency time and intercourse satisfaction as compared with fluoxetine alone in patients with premature ejaculation INTRODUCTION PSD502 is a novel aerosolized , lidocaine-prilocaine , spray being developed for the treatment of lifelong premature ejaculation . The clinical profile of PSD502 is described in one of two double-blind , placebo-controlled , phase III studies . AIM To determine the effect of PSD502 on the Index of Premature Ejaculation ( IPE ) and intravaginal ejaculatory latency ( IELT ) of men with lifelong PE . METHODS Men with lifelong PE who documented an IELT ≤ 1 minute with two or more of the first three sexual encounters during a 4-week baseline period were r and omized to receive double-blind treatment with PSD502 or placebo for 3 months . Patients completed IPE and Premature Ejaculation Profile question naires at entry and monthly visits , and recorded stop-watch timed IELT during each encounter . Safety was assessed by collecting adverse event data and st and ard safety measures . MAIN OUTCOME MEASURES Stopwatch timed IELT recordings and a patient-reported outcome question naire the IPE were used in this study to determine the effect of PSD502 applied topically 5 minutes before intercourse . RESULTS Two hundred fifty-six men with PE were r and omized from 38 centers in the U.S. , Canada , and Pol and .  The geometric mean IELT over the 3-month treatment period increased from a baseline of 0.56 minute and 0.53 minute in the PSD502 and placebo group respectively to 2.60 and 0.80 minute . There were significantly greater increases in the scores for the IPE domains of ejaculatory control , sexual satisfaction and distress in the PSD502 group than in the placebo group , with a mean 5.0 point difference between treatments in change from baseline in the IPE domain for ejaculatory control , 4.6 point difference in change from baseline in the IPE domain for sexual satisfaction , and a 2.5 point difference in change from baseline in the IPE domain for distress . This was supported by improvements in all secondary endpoints . CONCLUSION In this study , PSD502 applied topically to the glans penis 5 minutes before intercourse showed significantly improved ejaculatory latency , ejaculatory control , sexual satisfaction and distress and was shown to be well tolerated by patients and partners We investigated safety and efficacy of vardenafil and sertraline in  premature ejaculation ( PE ) . Seventy‐two men grade d their primary PE on a scale of 0–8 ( 0 = almost never , 8 = almost always ) . Intravaginal ejaculatory latency time ( IELT ) was measured . Patients were included if they scored their PE as 4 or greater and their IELTs were less than 1.30 min . After 6 weeks of behavioural psychosexual therapy , 49 patients still had a PE of 4 or greater and an IELT less than 1.30 min and they were r and omised : 6 weeks vardenafil ( 10 mg ) or sertraline ( 50 mg ) . After a wash‐out phase for 1 week , medication was changed in a cross‐over design . Initially , all 72 men with PE  received behavioural therapy .  Twenty‐three men were satisfied with treatment and excluded . The remaining 49 men grade d their PE as 5.94 ± 1.6 and IELT was 0.59 min and patients were r and omised . Four men discontinued the study  . Vardenafil  improved PE grading : 2.7 ± 2.1 ( P < 0.01 ) and IELT increased to 5.01 ± 3.69 ( P < 0.001 ) . PE grading improved 1.92 ± 1.32 , ( P < 0.01 ) and IELT 3.12 ± 1.89 ( P < 0.001 ) with sertraline . It is concluded that vardenafil and sertraline are useful agents in the pharmacological treatment of PE Seventeen male out patients with premature ejaculation were r and omly assigned to treatment with paroxetine ( N = 8) or placebo ( N = 9 ) . After a first week dose of 20 mg/day , the paroxetine regimen was increased to 40 mg/day for 5 weeks . Patients and their female partners were interviewed separately . Patients treated with paroxetine had significantly greater clinical improvement than the patients given placebo Purpose : To evaluate the efficacy and safety of most selective serotonin reuptake inhibitor drug , escitalopram , in delaying ejaculation in patients with premature ejaculation ( PE ) . Material s and Methods : A total of 276 married men ( mean age , 34.4 years ) with PE were r and omly assigned to receive 10 mg of escitalopram ( n = 138 ; Group 1 ) or placebo ( n = 138 ; Group 2 ) for 12 weeks . Pretreatment evaluation included history and physical examination , intravaginal ejaculatory latency time ( IELT ) , International Index of Erectile Function ( IIEF ) , and Meares-Stamey test . The efficacy of 2 treatments was assessed every 2 weeks during treatment , at the end of study , and in 3- and 6-month follow-up after cessation of treatment . Results : At the end of 12-week treatment , the escitalopram group had a 4.9-fold ( 95 % confidence interval [ CI ] , 3.14 - 6.12 ) increase of the geometric mean IELT , whereas after placebo , the geometric mean IELT did not increase significantly ( 1.4-fold increase ; 95 % CI , 0.86 - 1.68 ; P = 0.001 ) . Baseline mean intercourse satisfaction domain values of IIEF 10 and 11 reached to 16 and 10 at 12-week treatment in Groups 1 and 2 , respectively ( P = 0.01 ) . At the end of 6-month follow-up period , the geometric mean IELT in escitalopram and placebo group demonstrated 3.1- ( 95 % CI , 2.16 - 4.4 ) and 1.3-fold ( 95 % CI , 0.78 - 1.62 ) increase , respectively ( P = 0.001 ) . Three- and 6-month intercourse satisfaction domain values of IIEF were 15 and 14 in Groups 1 and 10 and 10 ( P = 0.01 ) in Group 2 , respectively . Mean number of adverse events was 22 for escitalopram and 9 for placebo ( P = 0.04 ) . Conclusions : Oral escitalopram is an effective treatment for PE with long-term benefit for the patient after it is withdrawn . Further studies are required to draw final conclusions on the efficacy of this drug in PE INTRODUCTION Dapoxetine is a short-acting selective serotonin reuptake inhibitor that was recently approved for the on-dem and treatment of  premature ejaculation ( PE ) . AIM To evaluate the efficacy and safety of dapoxetine 30 mg and 60 mg on dem and ( prn ) in men with PE from the Asia-Pacific region . METHODS This r and omized , double-blind , parallel-group ,  placebo-controlled trial enrolled men who were 18 years or older ; in a monogamous , heterosexual relationship for at least 6 months ; met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition , text revision , criteria for PE for at least 6 months ; and had an intravaginal ejaculatory latency time ( IELT ) of 2 minutes or less in at least 75 % of sexual intercourse episodes . Subjects received placebo , dapoxetine 30 mg , or dapoxetine 60 mg prn ( 1 - 3 hours before intercourse ) for 12 weeks . MAIN OUTCOME MEASURES Stopwatch-measured Average IELT , the Premature Ejaculation Profile ( PEP ) , Clinical Global Impression ( CGI ) of change in PE , treatment-emergent adverse events ( TEAEs ) . RESULTS Of the 1,067 subjects r and omized , 858 completed the study .  Mean Average IELT increased from approximately 1.1 minutes at baseline ( across groups ) to 2.4 , 3.9 , and 4.2 minutes with placebo , dapoxetine 30 mg , and dapoxetine 60 mg , respectively , and geometric mean Average IELT increased from approximately 0.9 minutes at baseline ( across groups ) to 1.8 , 2.7 , and 3.1 minutes , respectively ( fold-increases of 2.0 , 2.8 , and 3.3 , respectively ) . All PEP measures and the CGI of change were significantly improved with dapoxetine vs. placebo at study endpoint ( P < or = 0.005 for all ) . The most common TEAEs with dapoxetine included nausea , dizziness , somnolence , headache , vomiting , diarrhea , and nasopharyngitis ; TEAEs led to discontinuation in 0.3 % , 1.7 % , and 5.1 % of subjects with placebo , dapoxetine 30 mg , and dapoxetine 60 mg , respectively . CONCLUSIONS Dapoxetine treatment significantly prolonged IELT and improved PEP measures and was generally well tolerated in men with PE in the Asia-Pacific region PURPOSE The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined . MATERIAL S AND METHODS The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school . In this double-blind study the patients were r and omized into treatment groups receiving 20 mg . fluoxetine daily for 1 week and 40 mg . daily afterward ( group 1 ) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward ( group 2 ) . The groups were evaluated according to the latent period of intravaginal ejaculation . RESULTS The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2 . Nausea , headache and insomnia were reported side effects . CONCLUSIONS Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation
Pooled evidence suggested that topical anaesthetic creams ( TAs ) , tramadol , selective serotonin reuptake inhibitors ( SSRIs ) , and phosphodiesterase type 5 inhibitors ( PDE5is ) are more effective at prolonging IELT comparing with placebo .
Conclusions We recommend the initial use of dapoxetine 30 mg OD for PE because it has been tested in largest and better design ed clinical trials rather than it is more effective than the other drugs studied .
TAs and tramadol 50 mg OD can be used as a viable alternative to oral treatment with SSRIs .
PDE5is combined with SSRIs are more effective than SSRIs monotherapy but are also associated with more side effects .
Purpose The purpose of the study was to conduct a systematic evaluation of the different general prescribed drugs for  premature ejaculation ( PE ) .