Dapoxetine on demand for the treatment of premature ejaculation [Dapoxetina on demand nel trattamento dell'eiaculazione precoce]

Premature ejaculation (PE) is the most frequent sexual complaint. Its prevalence approaches 30% of the adult male population. Self-help remedies and psychotherapy continue to be widely used with modest results. Due to the role of the serotonin system in the pathophysiology of ejaculation, selective serotonin reuptake inhibitors (SSRI) have emerged during the last two decades as drugs capable of delaying ejaculation. Nevertheless none of them has been licensed for the treatment of PE due to their undesirable side effects in chronic administration. On this basis, a rapid-acting short half-life SSRI (dapoxetine) has been studied in the on-demand treatment of premature ejaculation. In double-blind, placebo-controlled trials, dapoxetine administered on demand (1-3 hours prior to intercourse) was seen to improve the intravaginal ejaculatory latency time (IELT) and the perception of control over ejaculation (two pivotal endpoints in clinical trials). Dapoxetine appeared to be safe and did not interfere with other drugs used in sexual complaints, such as PDE-5 inhibitors. More trials are needed to quantify the real long-term impact of on-demand use of this drug on the quality of life of patients and their partners. ©2010 Pharma Project Group srl.