Andrology Xagena

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Paroxetine in the treatment of premature ejaculation

Paroxetine is one of the selective serotonin reuptake inhibitors ( SSRIs ) used in the treatment of premature ejaculation.
However, this use is not approved in many countries.

The purpose of this systematic review and meta-analysis is to review the efficacy and safety of Paroxetine for patients with premature ejaculation.

Out of 493 unique articles, a total of 19 randomized, controlled trials ( RCTs ) were reviewed.

Pooled outcomes suggested that Paroxetine was more effective than placebo, Fluoxetine and Escitalopram at increasing IELT ( all p less than 0.05 ).
However, there existed a high level of heterogeneity in the Paroxetine versus Fluoxetine groups and the Paroxetine versus placebo groups.

Comparing Paroxetine with Tramadol, Sertraline, phosphodiesterase 5 inhibitors ( PDE5Is ), local Lidocaine gel, behaviour therapy or Dapoxetine, researchers found that the increase in IELT was not statistically significant between groups.

Paroxetine combined with Tadalafil or behaviour therapy was more efficacious than Paroxetine alone ( all p less than 0.05 ).

Although the side effects in the combination group were more common than in the Paroxetine alone group, the most common adverse events, such as nausea, muscle soreness, palpitation and flushing, were mild and tolerable.
The main limitations of this systematic review and meta-analysis were the different definitions of premature ejaculation and short follow-up times.

According to this systematic review and meta-analysis, Paroxetine has provided better efficacy than placebo, Fluoxetine and Escitalopram in the treatment of premature ejaculation, with well-tolerated side effects.
The combination group had better efficacy than the Paroxetine alone group. ( Xagena2019 )

Zhang D et al, BMC Urol 2019;19(1):2. doi: 10.1186/s12894-018-0431-7.