A Prospective Study Comparing Paroxetine Alone Versus Paroxetine Plus Sildenafil in Patients With Premature Ejaculation

Salonia, Andrea; Maga, Tommaso; Colombo, R.; Scattoni, Vincenzo; Briganti, Alberto; Cestari, Andrea; Guazzoni, Giorgio; Rigatti, Patrìzio; Montorsi, Francesco

doi:10.1097/00005392-200212000-00032

Cited by 72 publications

(135 citation statements)

References 21 publications

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“…Between 1973 and 2003, there have been 35 studies 15,17,23-25,60-79,80,81 on daily treatment with clomipramine, a tricyclic antidepressant, and on SSRIs (Table 2). In the same period, on-demand antidepressant treatment results were reported in eight studies [82][83][84][85][86][87][88][89] (Table 3). The current review consists of 3034 males obtained from 79 studies.…”

Section: General Results Of Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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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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Section: General Results Of Reviewmentioning

confidence: 99%

“…[33][34][35]67,76,85 Baseline periods ranged from 1 68,69 or 2 26,27 to mostly 4 weeks. 49,57,65,[77][78][79][80]89 In some studies, a certain number of intercourses 41,60,74,81 was taken as baseline measurement.…”

Section: Baseline Periodmentioning

confidence: 99%

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

et al. 2004

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“…IELT was prolonged in patients, who were taking sildenafil, but the difference was not statistically significant; this was probably because of the incorrect definition of PE used (IELT p2 min in 75% of intercourse attempts during the run-in period) or because of the fact that no treatment effect was found regardless of the criteria used to define PE. Salonia et al 17 showed improvements in stopwatch-measured IELT, sexual satisfaction and frequency of intercourse with sildenafil plus paroxetine over paroxetine alone in men with IELT o1 min. In a prospective randomized clinical trial, Wang et al 18 showed that sildenafil was superior to paroxetine and squeeze technique in improving IELT in men with PE and without ED.…”

Section: Discussionmentioning

confidence: 99%

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

et al. 2009

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Premature ejaculation (PE) is thought to be the most common male sexual dysfunction; however, the prevalence of lifelong (LL)-PE is relatively low. The aim of this study was to investigate the effects of on-demand vardenafil (10 mg) to modify the intravaginal ejaculatory latency time (IELT) in men with LL-PE without erectile dysfunction. Forty-two men (18-35 years) were enrolled in a 16-week, double-blind, placebo-controlled, cross-over study. Primary end point was the modification from baseline of IELT assessed by stopwatch technique; secondary end points were post-ejaculatory refractory time (PERT) and variations of scores at the Index of Premature Ejaculation questionnaire. The changes in geometric mean IELT were superior after taking vardenafil (0.6±0.3 vs 4.5 ± 1.1 min, Po0.01), compared with placebo (0.7 ± 0.3 vs 0.9 ± 1.0 min, ns). PERT dropped significantly after vardenafil (16.7 ± 2.0 vs 4.3 ± 0.9 min, Po0.001), compared with placebo (15.3±2.2 vs 15.8±2.3 min). Patients who took vardenafil (vs placebo) reported significantly (Po0.01) increased ejaculatory control (6±2 vs 16±2), improved overall sexual satisfaction (7±2 vs 15 ± 1) and distress (4 ± 1 vs 8 ± 1) scores, respectively. Multiple regression analysis (r 2 ¼ 0.86) for IELT by the number of attempts at sexual intercourse showed significant differences between the slopes of lines for placebo and vardenafil (Po0.0001). The most common adverse events for vardenafil (vs placebo) were headache (10 vs 3%), flushing (12 vs 0%) and dyspepsia (10 vs 0%), which tended to disappear over the time. In conclusion, in our study, vardenafil increased IELT and reduced PERT in men with LL-PE. Besides, improvements in confidence, perception of ejaculatory control and overall sexual satisfaction were reported.

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“…Therefore, the SV might be the most important target organ for the monitoring of ejaculatory responses. [4][5][6][7] Previous isolated rat SV studies have investigated the effects of drugs or electrical field stimulation (EFS) on the SV smooth muscle; generally, these studies have used the strip tissue preparation after removing the surrounding connective and fat tissues. Once the tissues were appropriately prepared, the isometric contractions of the suspended strip in the organ chamber were recorded.…”

Section: Introductionmentioning

confidence: 99%

A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

et al. 2008

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In this study, we evaluated the efficacy of a novel method of seminal vesicle (SV) preparation-ring preparation method-in isolated SV experiments in the rat. Rat SVs were prepared as strips and rings and applied to organ baths. The relaxation responses by sodium nitroprusside or doxazosin and contractile responses by electrical field stimulation (EFS) were recorded in both groups. We compared the proportion of tissues that showed consistent responses to the stimuli-drug or EFSin both groups. And magnitudes of the contractile or relaxation responses were also evaluated in the two groups. In strip preparations (n ¼ 20), six tissues (30%) showed stable responses to drugs and were regarded to be useful. However, in ring preparations (n ¼ 20), 13 tissues (65%) showed stable responses (Po0.001). Similarly, consistent contractile responses to the EFS were recorded in eight strips (40%) and 13 rings (65%) (n ¼ 20 in each group; Po0.05). The magnitudes of the relaxations by drugs were not different between the two methods (P ¼ 0.42) and the contractions by EFS were higher in ring preparations (Po0.05). The ring preparation seems to be better for responses to drugs and EFS compared with the strip preparations and, therefore, might be an alternative technique for in vitro SV experiments.

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A Prospective Study Comparing Paroxetine Alone Versus Paroxetine Plus Sildenafil in Patients With Premature Ejaculation

Cited by 72 publications

References 21 publications

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation

A novel method of seminal vesicle preparation in isolated seminal vesicle experiments in the rat: ring preparation

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