title: Tramadol HCL has promise in on-demand use to treat premature ejaculation.
abstract: BACKGROUND
  Premature ejaculation (PE) is a worldwide problem without an approved treatment. Selective serotonin reuptake inhibitors (SSRIs) are widely used "off label" as pharmacotherapeutic agents in the treatment of PE.
  
  
  OBJECTIVE
  This study investigates Tramadol efficacy for on-demand treatment of PE.
  
  
  METHODS
  Intravaginal ejaculation latency time (IELT) was used as an objective tool to assess the efficacy of the investigated treatments.
  
  
  METHODS
  Single-blind, placebo-controlled, crossover, stopwatch monitored two-period study was conducted, on 60 patients with lifelong PE. PE was defined as IELT of <2 minutes in 80% of intercourse episodes. A total of 25 mg of Tramadol hydrochloride was given to one group (30) prior to intercourse and placebo was supplied for the other group (30) for 8 weeks. Drugs were taken 1-2 hours before sexual activity and sexual intercourse was required at least once per week. After the initial treatment period, the two groups took the alternate medication for another 2 months. The two 8-week treatment periods were separated by 1 week washout period. IELT was timed by a stopwatch at each intercourse and was reported by patients or partners.
  
  
  RESULTS
  The baseline (mean +/- SD) IELT for patients before treatment was 1.17 +/- 0.39 minutes. At the end of the treatment period utilizing the active drug, the mean IELT was increased significantly in patients on Tramadol treatment to 7.37 +/- 2.53 minutes. The same patients on placebo medication had mean IELT of only 2.01 +/- 0.71 minutes. Patients uniformly reported satisfaction with their resulting control over ejaculation.
  
  
  CONCLUSIONS
  Tramadol, a drug with a proven safety record as an anti-inflammatory agent, shows promise as a drug for treating rapid ejaculation.
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. dr_emadsalaem@yahoo.com
authors.forename: Emad A
authors.initials: EA
authors.lastname: Salem
authors.forename: Steven K
authors.initials: SK
authors.lastname: Wilson
authors.forename: Nabil K
authors.initials: NK
authors.lastname: Bissada
authors.forename: John R
authors.initials: JR
authors.lastname: Delk
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Hellstrom
authors.forename: Mario A
authors.initials: MA
authors.lastname: Cleves
mesh_terms: D000284:Administration, Oral; D000328:Adult; D003075:Coitus; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D004542:Ejaculation / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018490:Serotonin Agents / Q000494:pharmacology / Q000627:therapeutic use*; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy*; D016037:Single-Blind Method; D014147:Tramadol / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018490:Serotonin Agents; D014147:Tramadol