Safety and efficacy of escitalopram in the treatment of premature ejaculation: a double-blind, placebo-controlled, fixed-dose, randomized study.
OBJECTIVE
To evaluate the efficacy and safety of most selective serotonin reuptake inhibitor drug, escitalopram, in delaying ejaculation in patients with premature ejaculation (PE).


METHODS
A total of 276 married men (mean age, 34.4 years) with PE were randomly assigned to receive 10 mg of escitalopram (n = 138; Group 1) or placebo (n = 138; Group 2) for 12 weeks. Pretreatment evaluation included history and physical examination, intravaginal ejaculatory latency time (IELT), International Index of Erectile Function (IIEF), and Meares-Stamey test. The efficacy of 2 treatments was assessed every 2 weeks during treatment, at the end of study, and in 3- and 6-month follow-up after cessation of treatment.


RESULTS
At the end of 12-week treatment, the escitalopram group had a 4.9-fold (95% confidence interval [CI], 3.14-6.12) increase of the geometric mean IELT, whereas after placebo, the geometric mean IELT did not increase significantly (1.4-fold increase; 95% CI, 0.86-1.68; P = 0.001). Baseline mean intercourse satisfaction domain values of IIEF 10 and 11 reached to 16 and 10 at 12-week treatment in Groups 1 and 2, respectively (P = 0.01). At the end of 6-month follow-up period, the geometric mean IELT in escitalopram and placebo group demonstrated 3.1- (95% CI, 2.16-4.4) and 1.3-fold (95% CI, 0.78-1.62) increase, respectively (P = 0.001). Three- and 6-month intercourse satisfaction domain values of IIEF were 15 and 14 in Groups 1 and 10 and 10 (P = 0.01) in Group 2, respectively. Mean number of adverse events was 22 for escitalopram and 9 for placebo (P = 0.04).


CONCLUSIONS
Oral escitalopram is an effective treatment for PE with long-term benefit for the patient after it is withdrawn. Further studies are required to draw final conclusions on the efficacy of this drug in PE.
Safarinejad
Mohammad Reza
MR
Department of Urology, Urology and Nephrology Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. safarinejad@unrc.ir
D000284:Administration, Oral; D000328:Adult; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003075:Coitus; D004311:Double-Blind Method; D004542:Ejaculation / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy*; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy*; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors