Articles

On-Demand Treatment of Premature Ejaculation with Citalopram: A Randomized Double-Blind Study

Abstract

As the most common male sexual disorder premature ejaculation (PE), also referred to as early ejaculation (EE) or rapid ejaculation (RE), affects 30%-40% of sexually active men. Despite the limited number of available studies comparing the efficacy of selective serotonin re-uptake inhibitors (SSRI) they have been thought to have beneficial effects for the treatment of patients with PE. In the present study, we assessed the efficacy of on-demand use of citalopram, in the treatment of premature ejaculation. A randomized double blind study of fixed dose on-demand use of citalopram was performed in Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences. The sample was consisted of 80 married patients diagnosed with PE according to Diagnostic and Statistical Manual of Mental Disorders. The patients were randomly assigned to two groups: group 1 consisting of 42 patients received 20mg citalopram, and group 2 consisting of 38 patients received placebo four hours before intercourse for a 4-week treatment course. The effects of drug on the ejaculatory function in each group were assessed by the intravaginal ejaculation latency time (IELT), and the Chinese Index of Premature Ejaculation (CIPE) before and at the end of treatment course. The mean IELT increased from 66.78±36.94 to 80.85±43.05 seconds in group 1 and from 63.44±33.16 to 65.71±34.26 seconds in group 2 (P = 0.000). Mean CIPE score increased 1.14±1.04 and 0.52±0.50 in group 1 and 2 respectively (P = 0.002). The patients treated with on demand citalopram showed significantly greater improvement in IELT and CIPE score compared to the patients receiving placebo. It seems that citalopram may be an effective treatment of premature ejaculation with on-demand usage. However further studies are warranted.

Montorsi F. Prevalence of premature ejaculation: a global and regional perspective. J Sex Med 2005;2 (Suppl 2):96-102.

Basile Fasolo C, Mirone V, Gentile V, Parazzini F, Ricci E; Andrology Prevention Week centers; Italian Society of Andrology (SIA). Premature ejaculation: prevalence and associated conditions in a sample of 12,558 men attending the andrology prevention week 2001: a study of the Italian Society of Andrology (SIA). J Sex Med 2005;2(3):376-82.

Screponi E, Carosa E, Di Stasi SM, Pepe M, Carruba G,Jannini EA. Prevalence of chronic prostatitis in men with premature ejaculation. Urology 2001;58(2):198-202.

McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study. J Urol 1998;159(6):1935-8.

Sadock BJ, Sadock VA. Abnormal sexuality and sexualdysfunctions. In: Sadock BJ, Sadock VA. Kaplan and Sadock's Synopsis of Psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 701-18.

Hsu JH, Shen WW. Male sexual side effects associated with antidepressants: a descriptive clinical study of 32 patients. Int J Psychiatry Med 1995;25(2):191-201.

Shen WW, Hsu JH. Female sexual side effects associated with selective serotonin reuptake inhibitors: a descriptive clinical study of 33 patients. Int J Psychiatry Med 1995;25(3):239-48.

Kowalsky A, Stanley RO, Dennerstein G. The sexual side effects of antidepressant medication: a double blind comparison of two antidepressants in a nonpsychiatric population. Br J Psychiatry 1985; 147: 413-418.

Rosen RC, Lane RM, Menza M. Effects of SSRIs on sexual function: a critical review. J Clin Psychopharmacol 1999;19(1):67-85.

McMahon CG, Touma K. Treatment of premature ejaculationwith paroxetine hydrochloride as needed: 2 singleblindplacebo controlled crossover studies. J Urol 1999;161(6):1826-30.

Murat Basar M, Atan A, Yildiz M, Baykam M, Aydogănli L. Comparison of sertraline to fluoxetine with regard to their efficacy and side effects in the treatment of premature ejaculation. Arch Esp Urol 1999;52(9):1008-11.

Kara H, Aydin S, Yücel M, Agargün MY, Odabas O, Yilmaz Y. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J Urol 1996;156(5):1631-2.

Rickels K, Schweizer E. Clinical overview of serotonin reuptake inhibitors. J Clin Psychiatry 1990;51 Suppl B:9-12.

Pollock BG. Citalopram: a detailed evaluation. Exp Opin Pharmacother 2001;2:681-98.

Yuan YM, Xin ZC, Jiang H, Guo YJ, Liu WJ, Tian L, et al. Sexual function of premature ejaculation patients assayed with Chinese Index of Premature Ejaculation. Asian J Androl 2004;6(2):121-6.

Atmaca M, Kuloglu M, Tezcan E, Semercioz A. The efficacy of citalopram in the treatment of premature ejaculation: a placebo-controlled study. Int J Impot Res 2002;14(6):502-5.

Waldinger MD, Olivier B. Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Investig Drugs 2004;5(7):743-7.

Remy L. The effect of selective 5HT re-uptake inhibitors on 5-methoxy-N, N-dimethyltriptamine induced ejaculation in the rat. Br J Pharmacol 1986; 87: 639-48.

Baldessarini RJ, Marsh E. Fluoxetine and side effects. Arch Gen Psychiatry 1990;47(2):191-2.

Decastro RM. Reversal of MAOI-induced anorgasmia with cyproheptadine. Am J Psychiatry 1985;142(6):783.

Sovner R. Impotence from the psychiatric standpoint. BMJm1984;1:697-9.

Girgis SM, El-Haggar S, El-Hermouzy S. A double-blind trial of clomipramine in premature ejaculation. Andrologia 1982;14(4):364-8.

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IssueVol 47, No 5 (2009) QRcode
SectionArticles
Keywords
SSRI citalopram placebo premature ejaculation

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How to Cite
1.
Farnia V, Raisi F, Mohseni MG, Atharikia D, Ghafuri Z. On-Demand Treatment of Premature Ejaculation with Citalopram: A Randomized Double-Blind Study. Acta Med Iran. 1;47(5):353-357.