Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study

Mathers, M.J.; Klotz, Theodor; Roth, Sandra P.; Lümmen, G.; Sommer, Frank

doi:10.1111/j.1439-0272.2008.00910.x

Cited by 50 publications

(57 citation statements)

References 34 publications

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“…Vardenafil: Recent small studies in men with lifelong PE compared vardenafil (Aversa et al, 2009) or sertraline in a randomized, prospective, crossover design (Mathers et al, 2009) and showed an increase in IELT as well as improvement in outcome measures with vardenafil as requested by the patient. In a laboratory setting, PDE5i seem to prolong the median duration of vibratory stimulation (ELT), but the difference from placebo was significant with vardenafil (P < 0.001).…”

Section: Pde5 Inhibitors (Pde5i)mentioning

confidence: 99%

The characterization, current medications, and promising therapeutics targets for premature ejaculation

Gür

Sikka

2015

Andrology

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SUMMARYPremature ejaculation (PE) is the most prevalent male sexual dysfunction. This is associated with negative personal and interpersonal psychological outcomes. The pharmacologic treatment of PE includes the use of antidepressants, local anesthetic agents, and phosphodiesterase type 5 inhibitors. While numerous treatments can control PE, only antidepressants and topical anesthetic creams and sprays have recently been shown to be more effective. This review focuses on the physiology and pharmacology of ejaculation, the pathophysiology of PE and the most effective pharmacological treatment of PE. Pharmacotherapy of PE with off-label shortacting selective serotonin reuptake inhibitors (SSRIs) is common, effective, and safe. Dapoxetine, a SSRI with a short half-life, has been recently evaluated for the treatment of PE by several countries and results are promising. In clinical practice, follow-up side effects are an important part of the management strategy for PE. The understanding of etiology, pathophysiology, and treatment modalities of PE would be beneficial to clinician in helping patients with this disappointing sexual problem.

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Section: Pde5 Inhibitors (Pde5i)mentioning

confidence: 99%

The characterization, current medications, and promising therapeutics targets for premature ejaculation

Gür

Sikka

2015

Andrology

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“…56 Two studies of vardenafil for PE showed that it increases IELT and reduces the post-ejaculation refractory period in men with lifelong PE. 58,59 A double-blind, prospective, crossover study compared the effectiveness of sildenafil with the squeeze technique and on-demand use of two different SSRIs (paroxetine and sertraline) and clomipramine in patients with primary PE. Sildenafil demonstrated a 15-fold increase in IELT compared with two-to fourfold increases for the other groups.…”

Section: Pde-5ismentioning

confidence: 99%

Current therapeutic strategies for premature ejaculation and future perspectives

Xin¹,

Zhu²,

Yuan³

et al. 2011

Asian J Androl

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Premature ejaculation (PE) is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used 'off-label', some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE. Ejaculation is a tightly coordinated activity with different ejaculatory organs and a spinal reflex initiated by genital and/or brain stimulation through the peripheral sensory receptors and regions, afferent pathways, the central nervous system ejaculatory centre of the brain (namely, sensory and motor areas located in the para-ventricular nucleus of the hypothalamus and the medial preoptic area). The spinal ejaculatory centre, located at the T 12 -L 1-2 spinal cord level (paragigantocellular), and its efferent pathway modulate the function of the ejaculatory organs. Ejaculation is also mediated by a complex interaction of central serotonergic and dopaminergic neurons with the secondary involvement of cholinergic, adrenergic, oxytocinergic and GABAergic neurons.Ejaculation consists of two main phases, the emission phase and the expulsion phase. The emissions include seminal fluid and secretions of the prostate and bulbourethral glands. In this phase, the contraction of accessory ejaculatory organs induces the accumulation of semen in the posterior urethra. Expansion of the posterior urethra creates a feeling of emission and sensory information that is transmitted to the spine via dorsal nerve sensory pathway and along the spinal cord up to the brain ejaculatory centre during the sexual arousal phase. The expulsion phase consists of the highly regular rhythmic contraction of striated muscles and the relaxation of smooth muscles in the ejaculatory ducts. The ejaculated semen can be divided into a number of components by serial biochemical analysis. 1 These include secretions from the seminal vesicles, prostate and bulbourethral (Cowper's) glands and spermatozoa.

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“…Mathers et al 43 reported that PE grade improved by 2.7 points in the vardenafil group vs 1.9 points in the sertraline group, and IELT increased by 5 min in the vardenafil group and by 3 min in the sertraline group. Wang et al 44 demonstrated the superiority of sildenafil vs paroxetine and squeeze technique, as well as Abdel-Ahmid et al, 45 who challenged patients with clomipramine and sertraline also.…”

Section: Pde5-i In Pementioning

confidence: 99%

Is there a role for phosphodiesterase type-5 inhibitors in the treatment of premature ejaculation?

et al. 2011

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Premature ejaculation (PE) is considered to be the most common male sexual dysfunction. The realization that PE may co-exist with ED prompted the use of PDE5-i's alone or in combination with selective serotonin reuptake inhibitors (SSRIs) for treating ejaculatory disorders. Until recently, there was little evidence that PDE5-i's alone may have a role in the treatment of PE in the absence of ED, and current available treatments include only on-demand dapoxetine. However, available data indicate that there is clinical, anatomical, physiological, pharmacological and genetic evidence to explain the efficacy of PDE5-i's. Nine manuscripts that examined the efficacy of PDE5-i's in the treatment of PE, alone or in combination with SSRIs, were retrieved. All studies reported some significant changes in the intravaginal ejaculatory latency time and sexual satisfaction scores, although not all were clinically meaningful. Well-designed multicenter studies are urgently required to further elucidate the efficacy and safety, as well as the mechanisms of action of PDE5-i's in the treatment of PE. The aim of this review is to discuss basic rationale and to show clinical evidence sustaining the possibility to use off-label PDE5-i's to treat PE.

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Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study

Cited by 50 publications

References 34 publications

The characterization, current medications, and promising therapeutics targets for premature ejaculation

The characterization, current medications, and promising therapeutics targets for premature ejaculation

Current therapeutic strategies for premature ejaculation and future perspectives

Is there a role for phosphodiesterase type-5 inhibitors in the treatment of premature ejaculation?

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