Medication for premature ejaculation

It is known that ejaculatory control is affected by levels of chemicals or neurotransmitters in the brain. Levels of serotonin and dopamine are known to affect control of and time to ejaculation. Some men who have premature ejaculation are thought to have lower levels of serotonin in certains areas of the brain.Boosting levels of serotonin in the brain seems to help in delaying ejaculation and medications which increase serotonin levels in the brain can be used to stop premature ejaculation.

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Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant medications such as fluoxetine (Prozac), paroxetine (Seroxat), sertraline (Lustral), fluvoxamine (Faverin) and citalopram (Cipramil) and escitalopram (Cipralex) have been found to have the effect of delaying ejaculation when men who were prescribed these drugs complained of delayed or difficulty ejaculating as a side effect. This side-effect was troublesome and a problem for some men who found that they were unable to ejaculate at all or suffered from retarded ejaculation.

An older antidepressant which is a tricyclic antidepressant, clomipramine (Anafranil) blocks the uptake of noradrenaline and serotonin and therefore increases brain levels of serotonin, has been known to be effective at stopping premature ejaculation for many years. Other tricyclic antidepressants such as amitriptyline block the uptake of noradreanaline but have a mininmal effect on serotonin and therefore seem to be ineffective at treating premature ejaculation.

Clearly those men who were too quick to ejaculate found the “side-effect” of delayed ejaculation a positive effect. Selective serotonin reuptake inhibitors are now prescribed by doctors as a treatment for premature ejaculation. The problem is that they have to be taken every day , need a doctors prescription and can have problematic side-effects such as nausea, drowsiness, increased anxiety, difficulty sleeping. They can also reduce sex desire and drive in some men. The effect of taking these drugs varies from person to person. There are also differences between the drugs within their class. By this I mean that some SSRI’s are more prone to cause anxiety, but paradoxically as a class of drugs they often tend to be calming and reduce anxiety. Some are licenced and used as a treatment for anxiety disorders and social phobia.

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Dapoxetine (Priligy)

Dapoxetine is a relatively new drug which is used to stop premature ejaculation. It is a short acting selective serotonin reuptake inhibitor (SSRI). As described above it is thought that increasing serotonin levels in the brain is a good way of treating premature ejaculation. SSRI anti-depressants have been frequently prescribed by physicians ‘off-label’ for many years to help men suffering from rapid ejaculation. Dapoxetine has found to be a extremely good at stopping premature ejaculation in medical studies. Dapoxetine is a short-acting SSRI, meaning that only a low amount of the drug remains in the body after a few hours. This is in contrast with SSRI antidepresants which remain in the tissues of the body for varying lengths of time from a few days to a few weeks (in the case of fluoxetine which as a half life of about seven days). This reduces most of the problematic side-effects typically found with SSRI’s and anti-depressant drugs. Dapoxetine is designed to be taken by mouth and only as required. It should be taken 1-3 hours before sexual activity.

In medical studies dapoxetine was found to be effective in treating premature ejaculation. It was found to increase the time to ejaculation (Intravaginal ejaculation latency time (IELT) is defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation) by a factor of three in many cases.

Dapoxetine in studies was found to have few side effects and is generally well tolerated. The commonest side effects described are nausea , headache and dizziness. Because dapoxetine has a short half-life these side effects were short lived in research trials.

Dapoxetine has been approved for use in many countries such as : Finland, Sweden, Austria, Portugal, Germany, Italy, Spain, and New Zealand. Approvals for dapoxetine are also expected in other European countries as well. In addition, filings for approval have been submitted in Australia, Canada, Turkey, Mexico and six other countries as well. In the United States, approval for dapoxetine is presently under review by the FDA.

Clomipramine (Anafranil) is a tricyclic antidepressant developed in the 1960’s. It blocks reuptake of serotonin and has been found to delay ejaculation. It is not approved by the US FDA for premature ejaculation but may be prescribed off-label for premature ejaculation by doctors if they feel it appropriate for individual patients. It can be administered orally or by nasal spray. Clomipramine has more side-effects that SSRI’s such as fluoxetine and citalopram.

A small study by Haensel et al in the Netherlands published in 1996 found that clomipramine (25mg taken as needed) delayed ejaculation in primary premature ejaculators. “Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation”

Tramadol is a synthetic opiate painkiller which has been tried and investigated as a treatment for premature ejaculation. A study published in the journal of clinical psychopharmacology in 2006 found that tramadol taken orally as needed before sexual intercourse increased the mean intravaginal time to ejaculation (intravaginal ejaculatory latency time) from 19 seconds to 243 seconds. There was no withdrawal effects caused by tramadol, but more adverse events were associated with tramadol treatment.

Another study published in the Journal of Sexual Medicine in 2008 investigated tramadol efficacy for on-demand treatment of premature ejaculation. The baseline (mean +/- SD) intravaginal ejaculatory latency time (IELT) for patients before treatment was 1.17 +/- 0.39 minutes. At the end of the treatment period utilizing the active drug, the mean intravaginal ejaculatory latency time (IELT) was increased significantly in patients on Tramadol treatment to 7.37 +/- 2.53 minutes. The same patients on placebo medication had mean IELT of only 2.01 +/- 0.71 minutes. Patients uniformly reported satisfaction with their resulting control over ejaculation. The authors conclusion was that Tramadol, a drug with a proven safety record as an anti-inflammatory agent, shows promise as a drug for treating rapid ejaculation.

There are many medications that will effectively stop premature ejaculation. The problem is that these all have side effects and require a doctors prescription. They also have a significant cost. Some are very expensive to buy. It is surely better to learn to treat premature ejaculation without resorting to drugs. Imagine being able to delay ejaculation as long as you and your partner wish without medication. This is possible by following the advice in Ejaculation Trainer.

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