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 ) .
The Efficacy and Safety of On-demand Tramadol and Paroxetine Use in Treatment of Life Long Premature Ejaculation: A Randomized Double-blind Placebo-controlled Clinical Trial
Background : Several medical therapies have been proposed for the treatment of  premature ejaculation ( PE ) .  Paroxetine and tramadol were both reported to be effective in treatment of PE . In this study , the therapeutic effects of tramadol , paroxetine and placebo were compared in treatment of primary PE . Methods : In this r and omized , double-blind , placebo-controlled clinical trial , 150 patients were divided into 3 groups . One group was treated with tramadol 50 mg ondem and , the other group took paroxetine 20 mg on-dem and and the third group was treated with placebo . Before starting treatment and after 12 weeks , patients were asked to measure their average intravaginal ejaculation latency time ( IELT ) and fill the PEP ( Premature Ejaculation Profile ) question naire . Results : At the end of the 12th week , the mean IELT and average of PEP scores improved in all 3 groups . The increase in tramadol group was significantly higher than the paroxetine and placebo groups ( p<0.0001 ) . There were no significant differences in terms of side effects between the 3 groups . Conclusion : The results showed that despite an increase in mean IELT and PEP scores in all 3 groups , the rate of improvement in tramadol group was significantly more than the others . Thus , tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE
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 ) .