title: Dapoxetine treatment in patients with lifelong premature ejaculation: the reasons of a "Waterloo".
abstract: OBJECTIVE
  To assess both the acceptance and the discontinuation rates from dapoxetine, the first oral pharmacological agent indicated for the treatment of premature ejaculation (PE).
  
  
  METHODS
  One hundred twenty consecutive potent patients (mean age 40.3 years; range 18-63 years) seeking medical treatment for lifelong PE were enrolled in a prospective phase II study. Moreover, they were assessed regarding detailed medical and sexual history, intravaginal ejaculatory latency time (IELT), International Index of Erectile Function (IIEF), and complete physical examination. The patients received a dapoxetine prescription (30 mg on demand) and unresponded cases received increased dose (60 mg after 3 months). The patients were evaluated at 1, 3, 6, and 12 months, and requested to complete a multiple-choice global assessment questionnaire regarding specific reasons for eventual therapy discontinuation.
  
  
  RESULTS
  Twenty-four of the patients (20%) decided not to start dapoxetine. Fear of using a "drug" was the most frequently reported reason for treatment nonacceptance (50%) and the cost of treatment was the reason for 25% of the patients. Ninety-six patients (80%) started the therapy. Twenty-six percent dropped out after 1 month, 42.7% dropped out after 3 months, 18.7% dropped out at 6 months, 2% dropped out at 12 months, and 10.4% are continuing the therapy after 1 year. The main reasons were effect below expectations 24.4%, costs 22.1%, side effects 19.8%, loss of interest in sex 19.8%, and no efficacy 13.9%.
  
  
  CONCLUSIONS
  Twenty percent of lifelong PE patients seeking medical treatment for early ejaculation freely decided not to start treatment with dapoxetine, and roughly 90% of the patients who started therapy discontinued after 1 year.
authors.affiliation: S Maria Annunziata Hospital, University of Florence, Italy. info@nicolamondaini.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Mondaini
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Fusco
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Silvia
authors.initials: S
authors.lastname: Benemei
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
mesh_terms: D000293:Adolescent; D000328:Adult; D001596:Benzylamines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005252:Fees, Pharmaceutical; D006801:Humans; D007989:Libido; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010352:Patient Dropouts; D061686:Premature Ejaculation / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D001596:Benzylamines; D009281:Naphthalenes; D017367:Selective Serotonin Reuptake Inhibitors; C080598:dapoxetine