Effect of Fluoxetine Alone and in Combination with Sildenafil in Patients with Premature Ejaculation

Hosseini, M.; Yarmohammadi, Hooman

doi:10.1159/000102909

Cited by 43 publications

(50 citation statements)

References 32 publications

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“…However, many patients, might not respond adequately to SSRIs, particularly those with erectile dysfunction(ED), likely because PE and ED are associated with each other 4,6 .Several recent studies have investigated the role of phosphodiesterase type 5(PDE-5) inhibitors, which are the first-line treatment for ED, reporting efficacy in the treatment of PE in the absence ofED [7][8] . It is noteworthy that PDE-5 inhibitors do not pharmacokinetically interact with SSRIs, and the combination of both is well tolerated 9 .In addition, efficacy and safety regarding the combination of PDE-5 inhibitors and SSRIs versus PDE-5 inhibitors or SSRIs monotherapy have also been investigated in the past decade [10][11][12][13] . A previous review has focused on this topic and suggested that combination therapy may be propitious to those who fail SSRI monotherapy or have concomitant ED and that it should not be the first-line M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 2 treatment for PE because of the adverse drug reactions 14 .…”

mentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis

Bai

Han

et al. 2015

Urology

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mentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis

Bai

Han

et al. 2015

Urology

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“…39,55,139,[142][143][144][145] Among these trials the dose was 50 mg or greater, administered a few hours preintercourse. Sildenafil was combined with fluoxetine in one trial 139 and with behavioural therapy in another, 143 i.e. there was no sildenafil-only arm in these two trials.…”

Section: 120mentioning

confidence: 99%

“…One RCT 55 that evaluated sildenafil and EMLA cream did not assess IELT. Post-treatment IELT data were available for one RCT assessing sildenafil and fluoxetine; 139 however, no variance estimates or p-values were reported. In one RCT assessing tadalafil and fluoxetine, 101 no IELT data were reported.…”

Section: Assessment Of Effectiveness: Phosphodiesterase-5 Inhibitors mentioning

confidence: 99%

Interventions to treat premature ejaculation: a systematic review short report

Cooper

James

Kaltenthaler

et al. 2015

Health Technology Assessment

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BackgroundPremature ejaculation (PE) is commonly defined as ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. PE can be either lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology.J Sex Marital Ther1989;15:130–4). Treatments include behavioural and pharmacological interventions.ObjectiveTo systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for PE.Data sourcesThe following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and theHealth Technology Assessmentdatabase; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched.MethodsRandomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life, treatment acceptability and adverse events (AEs).ResultsA total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all interventions except yoga. The following interventions demonstrated significant improvements (p < 0.05) in arithmetic mean difference in IELT compared with placebo:topical anaesthetics– eutectic mixture of local anaesthetics (EMLA®, AstraZeneca), topical eutectic mixture for PE (Plethora Solutions Ltd) spray;selective serotonin reuptake inhibitors(SSRIs) – citalopram (Cipramil®, Lundbeck), escitalopram (Cipralex®, Lundbeck), fluoxetine, paroxetine, sertraline, dapoxetine (Priligy®, Menarini), 30 mg or 60 mg;serotonin–noradrenaline reuptake inhibitors– duloxetine (Cymbalta®, Eli Lilly & Co Ltd);tricyclic antidepressants– inhaled clomipramine 4 mg;phosphodiesterase-5(PDE5)inhibitors– vardenafil (Levitra®, Bayer), tadalafil (Cialis®, Eli Lilly & Co Ltd);opioid analgesics– tramadol (Zydol SR®, Grünenthal). Improvements in sexual satisfaction and other outcomes compared with placebo were evident for SSRIs, PDE5 inhibitors and tramadol. Outcomes for interventions not compared with placebo were as follows:behavioural therapies– improvements over wait list control in IELT and other outcomes, behavioural therapy plus pharmacotherapy better than either therapy alone;alpha blockers– terazosin (Hytrin®, AMCO) not significantly different to antidepressants in ejaculation control;acupuncture– improvements over sham acupuncture in IELT, conflicting results for comparisons with SSRIs;Chinese medicine– improvements over treatment as usual;delay device– improvements in IELT when added to stop–start technique;yoga– improved IELT over baseline, fluoxetine better than yoga. Treatment-related AEs were evident with most pharmacological interventions.LimitationsAlthough data extraction from reviews was optimised when more than one review reported data for the same RCT, the reliability of the data extraction within these reviews cannot be guaranteed by this assessment report.ConclusionsSeveral interventions significantly improved IELT. Many interventions also improved sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is required to evaluate whether or not initial treatment effects are maintained long term, whether or not dose escalation is required, how soon treatment effects end following treatment cessation and whether or not treatments can be stopped and resumed at a later time. In addition, assessment of the AEs associated with long-term treatment and whether or not different doses have differing AE profiles is required.Study registrationThis study is registered as PROSPERO CRD42013005289.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…On the other hand, some research suggested that phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil also had efficacy in the treatment of PE [9,[24][25][26]. Hosseini et al chose 91 patients with PE who were given 20 mg fluoxetine daily or plus 50 mg sildenafil as needed [26].…”

Section: Sertraline (N=53)mentioning

confidence: 99%

Combination of Sertraline and Sildenafil versus Sertraline Monotherapy in the Treatment of Acquired Premature Ejaculation without Concomitant Diseases

Zhang¹

2014

Andrology

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Objective: To determine the efficacy and safety of sertraline monotherapy and combination therapy with sertraline and sildenafil in the treatment of APE without concomitant diseases. Methods:The study was conducted in 120 outpatients diagnosed with APE but without concomitant diseases. These patients were randomly divided into two groups: group A was treated with 50 mg sertraline daily; group B was treated with 50 mg sertraline daily and 50 mg sildenafil as needed. Assessment of the efficacy and safety of the two therapies was performed after 4 and 8 weeks. Patient or partner reports of Intravaginal Ejaculatory Latency Time (IELT), Premature Ejaculation Profile (PEP), Clinical Global Impression of Change (CGIC), and Treatment-Emergent Adverse Events (TEAEs) were assessed in this study. All the assessments were compared in the two groups after the treatment period. The efficacy was assessed by IELT, PEP and CGIC. On the other hand, safety was assessed by TEAEs.Results: 112 participants completed the study voluntarily. The two groups were similar regarding demographics. At the end of study period, both groups had significant improvements in IELT and PEP measures compared with pretreatment (P<0.001). Compared with group A, group B had significantly greater values of IELT (7.20 ± 2.93 vs. 5.04 ± 2.79), PEP measures, and CGIC (subjects reporting at least 'better': 58.2% vs. 35.8%) (P<0.05 for all). Adverse effects including headache, flushing, etc. were found in both groups, and the total incidence was higher in group B than group A (31.7% vs. 23.3%, respectively), but the difference was not significant. All the adverse effects were mild and tolerated. Conclusion:Both sertraline monotherapy and combination therapy with sildenafil and sertraline were efficacious and safe in the treatment of APE without concomitant diseases. The combination therapy had a higher efficacy than sertraline monotherapy without more adverse effects.

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Effect of Fluoxetine Alone and in Combination with Sildenafil in Patients with Premature Ejaculation

Cited by 43 publications

References 32 publications

Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis

Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis

Interventions to treat premature ejaculation: a systematic review short report

Combination of Sertraline and Sildenafil versus Sertraline Monotherapy in the Treatment of Acquired Premature Ejaculation without Concomitant Diseases

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