The previous PE-P Talk column correctly stated that treating premature ejaculation (PE) could become a hit-and-miss experiment in the absence of a scientifically proven and expert-recommended medication. Fortunately, men seeking an effective PE treatment no longer have to settle for guesswork and risk taking. Dapoxetine, the first and only drug specifically developed for the treatment of PE, is now available in the country.
A combination of psychological and physiological factors are involved in erection. The neurotransmitter serotonin (a chemical messenger in the brain and nervous system) plays a central role. Studies have shown that adequate levels of serotonin in the synapses (junctions between neurons or brain cells) help delay ejaculation. Men with PE have low levels of serotonin in the synapses, causing them to ejaculate soon after sexual activity and with minimal penile stimulation.
Dapoxetine works by inhibiting a protein (serotonin transporter) that removes serotonin from the synapses, thereby increasing the synaptic levels of serotonin and consequently delaying ejaculation. It is clinically proven to work effectively on the first dose for most men.
Dapoxetine significantly improves control over ejaculation (longer time before ejaculating) and enhances sexual satisfaction of the couple while reducing personal distress and interpersonal difficulty. Men with PE who are aged between 18 and 64 can take dapoxetine on-demand (as needed) one to three hours before intercourse.
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Prior to the availability of dapoxetine, selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline, fluvoxamine and citalopram were used as “off-label” drugs (used beyond the approved indication) to treat PE. However, these SSRIs must be taken daily in order to achieve meaningful efficacy, and the long half-life increases the risk of drug accumulation in the body, which increases the risk of adverse effects such as reduced sexual libido and erectile dysfunction.
Dapoxetine, on the other hand, is a fast-acting SSRI that is rapidly absorbed and eliminated from the body within a few hours. Its favorable pharmacokinetic profile minimizes the risk of accumulation in the body, thereby reducing side effects, making dapoxetine a suitable treatment for PE.
