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| |  Patients Prefer Daily Paroxetine for Premature Ejaculation: Presented at ESSM By Jill Stein LYON, France -- November 17, 2009 -- Men with primary premature ejaculation (PE) say they favour daily versus on-demand ingestion of the selective serotonin reuptake inhibitor (SSRI) paroxetine, researchers announced at the 12th Congress of the European Society of Sexual Medicine (ESSM). Juza Chen, MD, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, and associates reviewed the medical records of 111 men without erectile dysfunction who had been successfully treated for primary PE with paroxetine 20 mg for at least 2 years. “The organic factors involved in PE are not well understood, but serotonin [5-hydroxytryptamine] is important at the level of the central nervous system in the complex regulatory mechanisms involved in ejaculation,” Dr. Chen observed, speaking here at a presentation on November 16. “Selective serotonin reuptake inhibitor antidepressants -- paroxetine, fluoxetine, and sertraline -- and the tricyclic antidepressant clomipramine increase ejaculatory control and delay ejaculation in men with PE, suggesting that pharmacological intervention might be useful for PE.” While these agents are intended for chronic dosing for treating psychiatric disorders, their pharmacokinetic profiles and pharmacodynamic activity might represent shortcomings when used for treating PE, Dr. Chen continued. In fact, these properties might limit the usefulness of these drugs, whether administered on demand or chronically for the episodic treatment requirements of PE. On-demand treatment with SSRIs usually exerts much less ejaculation delay than daily SSRI treatment, however there is little information available on whether men with chronic PE prefer on-demand or daily drug treatment, he added. Participants in the trial were treated with paroxetine either daily or on-demand by their own choice. They were allowed to switch to the other regimen after a trial of at least 1 month. Overall, 62 (55.8%) men chose to start the medication on a daily basis, while 49 (44.1%) chose to start using it on demand. At some point over the next 2 years, 13 (20.9%) of the daily users converted to on-demand use, while 28 (57.1%) of the on-demand users switched to daily use. Further analysis revealed that most men cited convenience of drug administration when asked to name a single major reason for their preference. Overall, the results indicate that men prefer daily to on-demand paroxetine for treatment of their PE, Dr. Chen concluded. [Presentation title: Daily Versus On-Demand Dosage of Paroxetine for the Treatment of Premature Ejaculation. Abstract PO-09-007]
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