title: Pharmacotherapy for premature ejaculation.
abstract: BACKGROUND
  Four premature ejaculation (PE) subtypes are distinguished on the basis of the duration of the intravaginal ejaculation latency time (IELT), its course in life, and frequency of complaints. Since the 1930s oral drug treatment and local anesthetics have been used to treat PE. Apart from dapoxetine, all currently available drugs to treat PE (SSRIs, clomipramine, and local anesthetics) are off-label. Not only men with lifelong and acquired PE, but also men with normal IELT values may want to postpone their ejaculation time.
  
  
  METHODS
  The guideline of the International Society for Sexual Medicine for the treatment of PE has provided evidence-based recommendations for the pharmacotherapy of lifelong and acquired PE. Selective serotonin reuptake inhibitors (SSRIs) delay ejaculation by interfering with the serotonin (5-HT) neurotransmission system in the central nervous system. Attention is given not only to the well-known but also to the recently published, very rare side effects of SSRIs.
  
  
  CONCLUSIONS
  Men with normal IELT values who want to postpone ejaculation do not need "drugs for the treatment of PE" but "ejaculation delaying drugs." Pharmacological research of these ejaculation-delaying drugs ought to be investigated in men with normal IELT values, such as in men with subjective PE, variable PE, and in male volunteers.
authors.affiliation: a Drexel University College of Medicine, Department of Pharmacology and Physiology , Philadelphia , USA.
authors.forename: Marcel D
authors.initials: MD
authors.lastname: Waldinger
mesh_terms: D004542:Ejaculation / Q000187:drug effects; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D061686:Premature Ejaculation / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: clomipramine; dapoxetine; local anesthetics; post selective serotonin reuptake inhibitors sexual dysfunction; premature ejaculation; selective serotonin reuptake inhibitors; serotonin