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 ) .
Antidepressants and Ejaculation: A Double-Blind, Randomized, Placebo-Controlled, Fixed-Dose Study With Paroxetine, Sertraline, and Nefazodone
Antidepressant medication is often associated with sexual side effects . A double-blind , placebo-controlled study in men with lifelong rapid ejaculation was performed to assess the effects of two selective serotonin ( 5-HT ) reuptake inhibitors — paroxetine and sertraline— and the 5-HT 2 antagonist and 5-HT/noradrenaline reuptake inhibitor nefazodone on the latency to ejaculate . Forty-eight men with an intravaginal ejaculation latency time ( IELT ) of a maximum of 1 minute were r and omly assigned to receive paroxetine ( 20 mg/day ) , sertraline ( 50 mg/day ) , nefazodone ( 400 mg/day ) , or placebo for 6 weeks . During the 1-month baseline and 6-week treatment period , IELTs were measured at home with a stopwatch . The trial was completed by 40 men . During the 6-week treatment period , the geometric mean IELT in the placebo group was stable at approximately 20 seconds . Analysis of variance revealed a between-group difference in the evolution of IELT delay over time ( p = 0.002 ) ; the IELT after paroxetine and sertraline gradually increased to approximately 146 and 58 seconds , respectively , compared with 28 seconds in the nefazodone group . The paroxetine and sertraline groups differed significantly ( p < 0.001 and p = 0.024 , respectively ) from placebo , but the nefazodone group did not ( p = 0.85 ) . Compared with baseline , paroxetine exerted the strongest delay in ejaculation , whereas sertraline delayed it only moderately . There was no clinical ly relevant delay in ejaculation with nefazodone
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 ) .