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 ) .
A randomized, double-blind, placebo-controlled, crossover trial of “on-demand” tramadol for treatment of premature ejaculation
Objectives : The objective of this study is to assess the dose-related effects of tramadol on a group of patients with premature ejaculation ( PE ) . Subjects and Methods : During the period of months between June 2010 and July 2012 , 180 PE patients presented to outpatient clinic of our hospital . Patients were r and omized in a 1:1:1 fashion to receive different sequences of the three medications : placebo , 50 mg of tramadol and 100 mg of tramadol . Every patient received 10 doses of each medication for 2 months . Intra-vaginal ejaculatory latency time ( IELT ) was recorded in seconds initially and for each arm . Successful treatment of PE is defined if IELT exceeded 120 s. Side-effects of medications were reported . Results : Of patients enrolled , 125 ( 69.4 % ) continued the study . Patients ′ age range was 20 - 55 years with PE complaint of 1 to 10 years duration .  Mean IELT was 72 at presentation , 82 for placebo , 150 for tramadol 50 mg , and 272 for tramadol 100 mg ( P < 0.001 for all comparisons ) . PE was successfully treated in only 2.4 % of patients with placebo , in contrast to 53.6 % and 85.6 % with 50 and 100 mg tramadol , respectively ( P < 0.001 for all comparisons ) . On multivariate logistic regression analysis , baseline IELT was the only predictor of successful treatment of PE with both tramadol 50 mg ( odds ratio [ OR ] : 1.05 , 95 % confidence interval [ CI ] : 1.03 - 1.07 , P < 0.001 ) and tramadol 100 mg ( OR : 1.07 , 95 % CI : 1.04 - 1.11 , P < 0.001 ) . Postmicturition dribble annoyed 12.8 % of those who received 50 mg tramadol and 33.6 % of those who received 100 mg tramadol ( P < 0.001 ) . Weak scanty ejaculation was the main complaint in 7.2 % versus 21.6 % of those using 50 and 100 mg tramadol , respectively ( P = 0.002 ) . Two patients discontinued tramadol 100 mg due to side-effects . Conclusion : Tramadol hydrochloride exhibits a significant dose-related efficacy and side-effects over placebo for treatment of 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 ) .