Comparison of Dapoxetine /Tadalafil and Paroxetine/Tadalafil Combination Therapies for the Treatment of the Premature Ejaculation: A Randomized Clinical Trial Combination therapy of Dapoxetine and Paroxetine
Urology Journal,
Vol. 19 No. 02 (2022),
,
Page 138-143
https://doi.org/10.22037/uj.v18i.6644
Abstract
Purpose: The purpose of this study was to compare the effectiveness of Dapoxetine, and Paroxetine as well as Dapoxetine/Tadalafil and Paroxetine/Tadalafil combinational therapies, for the treatment of patients with premature ejaculation.
Materials and Methods: In this clinical trial study, 120 patients with premature ejaculation were randomly divided into 4 groups: The first group was treated with Paroxetine (Pa), while the second group received Dapoxetine(Da). The third group received Paroxetine combined with Tadalafil(PT) whereas the fourth group's treatment involved the use of Dapoxetine and Tadalafil(DT) for one month. In the next 2 and 4 weeks, the cases were evaluated in terms of ejaculation duration, frequency of intercourse per week, and drug side effects.
Results: The mean age of the Da, Pa, PT, DT groups was 32 ± 6.9, 32.4 ± 7.2, 31.6 ± 1.9, and 32.9 ± 7.7 years, respectively. There was a significant difference between the Da and DT groups (p = .029) in the ejaculation latency in the 4-week follow-up. In the two weeks follow-up, a significant difference was observed between DA and DT (p = 0.043), Pa and PT (p = 0.006), and Pa and DT groups (p = 0.004) in terms of ejaculation latency. Four weeks after the intervention, a significant difference was detected in the intercourse frequency of Da and PT groups (p =0.033), Pa and PT groups (p = 0.043), Pa and DT groups (p = 0.02), and Da and DT groups (p = 0.016).
Conclusion: Combination therapy (Tadalafil plus Paroxetine or Dapoxetine) was more effective in IELT (Intra ejaculation latency time) than mono-therapy especially in younger patients despite its slightly more side effects.
- premature ejaculation, paroxetine, sildenafil, dapoxetine
How to Cite
References
Moudi E, Kasaeeyan AA. Comparison between tadalafil plus paroxetine and paroxetine alone in the treatment of premature ejaculation. NU monthly. 2016;27:32-48.
Mirone V, Arcaniolo D, Rivas D, et al. Results from a prospective observational study of men with premature ejaculation treated with dapoxetine or alternative care: the PAUSE study. Eur Urol. 2014;1:733-9.
Reza KB, Safarinezhad M. A survey of prevalence of sexual disorders and risk factors in patient who referred in urology ward in 501 hospital 2004-05. Ann Mil Health Sci Res. 2007;4:1041-5.
Tanagho EA, McAninch JW. Smith's general urology. McGraw Hill. 2008;1:345-9
Sangkum P, Badr R, Serefoglu EC, et al. Dapoxetine and the treatment of premature ejaculation. Transl Androl Urol. 2013;2:301-11.
Montorsi F, Adaikan G, Becher E, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7:3572-88.
Waldinger MD, Schweitzer DH. The use of old and recent DSM definitions of premature ejaculation in observational studies: A contribution to the present debate for a new classification of PE in the DSM‐V. J Sex Med. 2008;5:1079-87.
Buvat J. Pathophysiology of premature ejaculation. J Sex Med.. 2011;8:316-27.
Yang X, Gao M, Zhang L, et al. Central neural correlates during inhibitory control in lifelong premature ejaculation patients. Front Hum Neurosci. 2018;12:206-15.
Peeters M, Giuliano F. Central neurophysiology and dopaminergic control of ejaculation. Neurosci Biobehav Rev. 2008;32:438-53.
Corona G, Mannucci E, Jannini EA, et al. Original research–endocrinology: Hypoprolactinemia: A New Clinical Syndrome in Patients with Sexual Dysfunction. J Sex Med. 2009;6:1457-66.
Patrick DL, Rowland D, Rothman M. Ejaculatory Disorders: Interrelationships Among Measures of Premature Ejaculation: The Central Role of Perceived Control. J Sex Med. 2007;4:780-8.
Paço JS, Pereira BJ. New therapeutic perspectives in premature ejaculation. Urology. 2016;88:87-92.
Zhang X, Tang D, Yang J, et al. Combination of sertraline and sildenafil versus sertraline monotherapy in the treatment of acquired premature ejaculation without concomitant diseases. Andrology. 2014;3:2167-250.
Dell'Atti L, Galosi AB, Ippolito C. A randomized single-center study to compare the efficacy and tolerability of tadalafil once daily plus lidocaine anesthetic spray on premature ejaculation. Eur Rev Med Pharmacol Sci. 2017;21:1036-40.
Jern P, Johansson A, Piha J, et al. Antidepressant treatment of premature ejaculation: discontinuation rates and prevalence of side effects for dapoxetine and paroxetine in a naturalistic setting. Int J Impot Res. 2015;27:75-80.
Abu El‐Hamd M, Abdelhamed A. Comparison of the clinical efficacy and safety of the on‐demand use of paroxetine, dapoxetine, sildenafil and combined dapoxetine with sildenafil in treatment of patients with premature ejaculation: A randomised placebo‐controlled clinical trial. Andrologia. 2018;50:128-39.
Martyn-St James M, Cooper K, Ren S, et.al. Phosphodiesterase type 5 inhibitors for premature ejaculation: a systematic review and meta-analysis. Eur Urol Focus. 2017;3:119-29.
McMahon CG, Althof SE, Kaufman JM, et.al. Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of results from five phase 3 trials. J Sex Med. 2011;8:524-39.
Pryor JL, Althof SE, Steidle C, et.al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet. 2006;368:929-37.
Giuliano F, Patrick DL, Porst H, et al. Premature ejaculation: results from a five-country European observational study. Eur Urol. 2008;53:1048-57.
Castiglione F, Albersen M, Hedlund P, et al. Current pharmacological management of premature ejaculation: a systematic review and meta-analysis. Eur Urol. 2016;69: 904-16.
Safarinejad MR. Comparison of dapoxetine versus paroxetine in patients with premature ejaculation: a double-blind, placebo-controlled, fixed-dose, randomized study. Clin Neuropharmacol. 2006;29:243-52.
Li J, Liu D, Wu J, et al. Dapoxetine for the treatment of premature ejaculation: a meta-analysis of randomized controlled trials with trial sequential analysis. Ann Saudi Med. 2018;38:366-75.
McMAHON CG, Touma K. Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies. Urol. 1999;161:1826-30.
AkgÃl T, Karakan T, Ayyildiz A, et al. Comparison of sertraline and citalopram for treatment of premature ejaculation. Urol. 2009;5:41-5.
Simsek A, Kirecci SL, Kucuktopcu O, et al. Comparison of paroxetine and dapoxetine, a novel selective serotonin reuptake inhibitor in the treatment of premature ejaculation. Asian J. Androl. 2014;16:700-25.
Moudi E, Kasaeeyan AA. Comparison between tadalafil plus paroxetine and paroxetine alone in the treatment of premature ejaculation. NU monthly. 2016;8:234-45.
Hutchinson K, Cruickshank K, Wylie K. A benefit-risk assessment of dapoxetine in the treatment of premature ejaculation. Drug Saf. 2012;35:359-72.
McMahon CG. Dapoxetine: a new option in the medical management of premature ejaculation. Ther Adv Urol. 2012;4:233-51.
Polat EC, Ozbek E, Otunctemur A, et al. Combination therapy with selective serotonin reuptake inhibitors and phosphodiesterase‐5 inhibitors in the treatment of premature ejaculation. Andrologia. 2015;47:487-92.
Gameel TA, Tawfik AM, Abou-Farha MO, et al. On-demand use of tramadol, sildenafil, paroxetine and local anaesthetics for the management of premature ejaculation: a randomised placebo-controlled clinical trial. Arab J Urol. 2013;11:392-7.
Lee WK, Lee SH, Cho ST, et al. Comparison between on‐demand dosing of dapoxetine alone and dapoxetine plus mirodenafil in patients with lifelong premature ejaculation: Prospective, randomized, double‐blind, placebo‐controlled, multicenter study. J Sex Med. 2013;10:2832-41.
F Lasker G, Halis F, Gokce A. Selective serotonin reuptake inhibitors for premature ejaculation: review of erectile and ejaculatory side effects. Curr. Drug Saf. 2014;9:118-26.
- Abstract Viewed: 0 times
- 6644/pdf Downloaded: 0 times