The mechanism through which<unk>  affects premature ejaculation is still unclear, but<unk>  is presumed to work by inhibiting serotonin transporter and subsequently increasing serotonin's action at pre- and postsynaptic receptors. Human ejaculation is regulated by various areas in the central nervous system (CNS). The ejaculatory pathway originates from spinal reflex at the thoracolumbar and lumbosacral level of spinal cord activated by stimuli from male genitalia. These signals are relayed to the brain stem, which then is influenced by a number of nuclei in the brain such as medial preoptic and paraventricular nuclei. Clement's study performed on anaesthetized male rats showed that acute administration of<unk>  inhibits ejaculatory expulsion reflex at supraspinal level by modulating activity of lateral paragigantocellular nucleus (LPGi) neurons. These effects cause an increase in pudendal motoneuron reflex discharge (PMRD) latency, though whether<unk>  acts directly on LPGi or on the descending pathway in which LPGi located is unclear.
Dapoxetine
Atomoxetine
Duloxetine
Edivoxetine
Vortioxetine
Fluoxetine
Nabilone
Guanfacine