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      A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire

      1 , 2 , 1

      Therapeutics and Clinical Risk Management

      Dove Medical Press

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          Abstract

          Aim

          This study reports the results of a large prospective single-blinded clinical trial of 3 SSRI (paroxetine, fluoxetine and escitalopram) in PE using a validated questionnaire.

          Methods

          A total of 100 normally potent men suffering from PE were enrolled in a randomized single-blinded comparative study of fluoxetine, paroxetine and escitalopram Patients were randomized into 3 treatment groups. Group 1 comprised 33 men who received fluoxetine 20 mg daily, group 2 comprised 37 men who received escitalopram 10 mg and group 3 comprised 30 men who received paroxetine 20 mg daily. All drug regimens were given in early morning dose and continued for 4 weeks.

          Results

          All 100 (100%) patients experienced a significant increase in their AIPE total score after drug treatment. There was no significant difference regarding any of the 7 items of the AIPE between the 3 treatment groups. All 3 drugs were generally well tolerated.

          Conclusions

          Our relatively large study, using a validated questionnaire confirmed similar useful effect of paroxetine, fluoxetine and escitalopram on ejaculation time. Further large cohort studies with long-term follow up are needed to evaluate the sustained effects of these drugs on ejaculation latency.

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          Most cited references 19

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          Diagnostic and statistical manual of mental disorders.

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            Paroxetine treatment of premature ejaculation: a double-blind, randomized, placebo-controlled study.

            Seventeen male outpatients with premature ejaculation were randomly 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.
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              Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis.

              The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies (3034 males), published between 1943 and 2003, are reviewed. A meta-analysis is performed on 43 selective serotonin reuptake inhibitors (SSRIs) and clomipramine studies (1514 males), published between 1973 and 2003; these studies were pooled to provide a summary variance-weighted effect size. The antidepressant-induced percentage increase of the intravaginal ejaculation latency time (IELT) was calculated and examined against various methodological items. A significant difference in efficacy between SSRIs was observed. Using daily treatment, paroxetine appeared more effective than the other SSRIs. Retrospective use of a questionnaire, subjective reports, single-blind and open study designs generate far greater variability of ejaculation time both at baseline and during active drug treatment than real time assessment by stopwatch. In conclusion, at daily treatment, the overall efficacy of paroxetine, clomipramine, sertraline and fluoxetine is comparable, but paroxetine exerts the strongest ejaculation delay. Only eight (18.5%) studies on antidepressant treatment fulfilled all criteria used in evidence-based medicine, for example, randomised, double-blind studies with prospective real time (stopwatch) assessment of the IELT at each intercourse. Single-blind studies, open designs, retrospective reporting, or the use of a questionnaire to assess ejaculation time should be avoided.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                August 2007
                August 2007
                : 3
                : 4
                : 527-531
                Affiliations
                [1 ]Andrology department, Cairo University hospital Cairo, Egypt
                [2 ]Dr Fakhry hospital El-Khobar, Saudi Arabia
                Author notes
                Correspondence: Rany Shamloul University of Saskatchewan, Department of Physiology, 107 Wiggins Road Saskatoon, SK, Canada S7N5E5 Tel +1 306 966 1848 Fax +1 306 966 6532 Email: rannone74@ 123456hotmail.com
                Article
                2374931
                18472973
                © 2007 Dove Medical Press Limited. All rights reserved
                Categories
                Review

                Medicine

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