title: Genetic polymorphism in the serotonin transporter gene-linked polymorphic region and response to serotonin reuptake inhibitors in patients with premature ejaculation.
abstract: OBJECTIVE
  Serotonin plays a central role in ejaculation and selective serotonin reuptake inhibitors have been successfully used to treat premature ejaculation. Here, we evaluated the relationship between a polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the response of patients with premature ejaculation to SSRI medication.
  
  
  METHODS
  Sixty-nine premature ejaculation patients were treated with 20 mg/d paroxetine for three months. The Intravaginal Ejaculatory Latency Time and International Index of Erectile Function scores were compared with baseline values. The patients were scored as having responded to therapy when a 2-fold or greater increase was observed in Intravaginal Ejaculatory Latency Time compared with baseline values after three months. Three genotypes of 5-HTTLPR were studied: LL, LS and SS. The appropriateness of the allele frequencies in 5-HTTLPR were analyzed according to Hardy-Weinberg equilibrium using the χ2-test.
  
  
  RESULTS
  The short (S) allele of 5-HTTLPR was significantly more frequent in responders than in nonresponders (p<0.05). Out of the 69 total PE patients, 41 patients (59%) responded to therapy. There was no significant difference in the International Index of Erectile Function score at the end of therapy between the responder and nonresponder groups. The frequencies of the L allele and S allele were 20% and 39%, respectively, in the responder group (p<0.05).
  
  
  CONCLUSIONS
  We conclude that premature ejaculation patients with the SS genotype respond well to selective serotonin reuptake inhibitor therapy. Further studies with large patient groups are necessary to confirm this conclusion.
authors.affiliation: Department of Urology, Izmir Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Ozbek
authors.affiliation: Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Otunctemur
authors.affiliation: Department of Urology, Sultanciftligi State Hospital, Istanbul, Turkey.
authors.forename: Abdulmuttalip
authors.initials: A
authors.lastname: Simsek
authors.affiliation: Department of Urology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Emre Can
authors.initials: EC
authors.lastname: Polat
authors.affiliation: Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Ozcan
authors.affiliation: Department of Urology, Izmir Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Köse
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cekmen
mesh_terms: D000328:Adult; D005787:Gene Frequency; D056726:Genetic Association Studies; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D061686:Premature Ejaculation / Q000188:drug therapy* / Q000235:genetics; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017374:Paroxetine; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human