Pooled evidence suggested that topical anaesthetic creams ( TAs ) , tramadol , selective serotonin reuptake inhibitors ( SSRIs ) , and phosphodiesterase type 5 inhibitors ( PDE5is ) are more effective at prolonging IELT comparing with placebo .
Conclusions We recommend the initial use of dapoxetine 30 mg OD for PE because it has been tested in largest and better design ed clinical trials rather than it is more effective than the other drugs studied .
TAs and tramadol 50 mg OD can be used as a viable alternative to oral treatment with SSRIs .
PDE5is combined with SSRIs are more effective than SSRIs monotherapy but are also associated with more side effects .
Purpose The purpose of the study was to conduct a systematic evaluation of the different general prescribed drugs for  premature ejaculation ( PE ) .
On-demand tramadol hydrochloride use in premature ejaculation treatment.
OBJECTIVES To determine the efficacy of tramadol in premature ejaculation ( PE ) treatment compared with placebo . METHODS A single-blind , placebo-controlled , crossover study was conducted with 60 lifelong ( primary ) patients with PE . The patients were r and omized into 2 groups , each consisting of 30 patients , who took tramadol or placebo on dem and . PE was defined as an intravaginal ejaculation latency time of ≤60 seconds in 90 % of intercourse episodes . The efficacy of the drugs was assessed using the intravaginal ejaculation latency time , ability of ejaculation control , and sexual satisfaction scores after an 8-week treatment period . RESULTS All participants completed the study voluntarily . Two groups were similar in terms of the patient demographics . Increases in the intravaginal ejaculation latency time , ability of ejaculation control , and sexual satisfaction score between the placebo and tramadol groups were compared with the baseline values in both groups . At the end of study period , the tramadol group had significantly ( P<.001 ) greater values for all 3 parameters compared with those in the placebo group . CONCLUSIONS On-dem and use of low-dose tramadol is effective for lifelong PE . Currently , selective seratonin reuptake inhibitors such as dapoxetine , are a more popular treatment option for PE . However , tramadol might be considered an alternative agent for primary PE treatment
Pooled evidence suggested that topical anaesthetic creams ( TAs ) , tramadol , selective serotonin reuptake inhibitors ( SSRIs ) , and phosphodiesterase type 5 inhibitors ( PDE5is ) are more effective at prolonging IELT comparing with placebo .
Conclusions We recommend the initial use of dapoxetine 30 mg OD for PE because it has been tested in largest and better design ed clinical trials rather than it is more effective than the other drugs studied .
TAs and tramadol 50 mg OD can be used as a viable alternative to oral treatment with SSRIs .
PDE5is combined with SSRIs are more effective than SSRIs monotherapy but are also associated with more side effects .
Purpose The purpose of the study was to conduct a systematic evaluation of the different general prescribed drugs for  premature ejaculation ( PE ) .