Clomipramine and sexual function in men with premature ejaculation and controls.
OBJECTIVE
We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls.


METHODS
The study included 8 patients with primary premature ejaculation, 6 with premature ejaculation and erectile dysfunction, and 8 controls. A prospective, double-blind, placebo controlled, crossover design was used that included 2, 3-week periods with clomipramine and placebo. During treatment phases subjects took either 25 mg. clomipramine or placebo as needed, that is 12 to 24 hours before anticipated sexual activity (coitus or masturbation). Subjects also visited the laboratory during these phases for evaluation of sexual response using visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phases.


RESULTS
Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation. There were no significant effects in controls and men with premature ejaculation plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejaculatory response with clomipramine therapy. In these men clomipramine also resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects.


CONCLUSIONS
Clomipramine (25 mg. as needed) effectively increases ejaculatory latency in men with primary premature ejaculation, while treatment is not effective in those with premature ejaculation and erectile dysfunction.
Haensel
S M
SM
Department of Endocrinology and Reproduction, Erasmus University, Rotterdam, The Netherlands.
Rowland
D L
DL
Kallan
K T
KT
D000328:Adult; D002997:Clomipramine / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004542:Ejaculation / Q000187:drug effects*; D007172:Erectile Dysfunction / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013997:Time Factors
D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors