Premature ejaculation (PE) is one of the most common sexual dysfunction problems, which has significant adverse effects on the life quality of the patients. Behavioral therapies have been the mainstay of PE management for many years. However, there is inadequate evidence for their long-term benefit. There are currently no medications licensed specifically for the treatment of PE. Current " off-label" pharmacotherapeutic approaches include topical anesthetics, phosphodiesterase-5 inhibitors, and serotonin reuptake inhibitors, all of which, however, fall short of the ideal therapy for PE. In the absence of a cure, the ideal treatment that researches aim at should be tolerable, effective from the first dose, rapid in onset of action, fast in elimination, and available as an oral medication. It is anticipated that agents being developed for the specific indication of PE will come closer to this ideal than the existing pharmacotherapeutic approaches.
Benzylamines ; therapeutic use ; Humans ; Male ; Naphthalenes ; therapeutic use ; Serotonin Uptake Inhibitors ; therapeutic use ; Sexual Dysfunction, Physiological ; drug therapy

No abstract available.
Amitriptyline/*therapeutic use ; Antidepressive Agents, Tricyclic/*therapeutic use ; Citalopram/*therapeutic use ; Dyspepsia/*drug therapy ; Female ; Humans ; Male ; *Quality of Life ; Serotonin Uptake Inhibitors/*therapeutic use

OBJECTIVETo evaluate the efficacy and safety of sertraline and vardenafil in the treatment of patients with concomitant erectile dysfunction (ED) and premature ejaculation (PE).

METHODSSixty patients with concomitant ED and PE received at our clinic of andrology were randomly divided into a vardenafil group and a sertraline group. The vardenafil group received flexible doses of vardenafil from 10 mg to 20 mg and the sertraline group 50 mg daily, both for 2 months. The differences in IIEF-5 before and after the treatment were recorded and compared, and the results of ED treatment evaluated. Intravaginal ejaculatory latency time (IELT) was recorded to evaluate the outcome of PE treatment.

RESULTSIn the vardenafil group, 24 patients had their ED improved and the efficacy rate was 80%, as compared with 27% in the sertraline group. There was significant difference between the two groups (P < 0.05). Twenty patients had their PE improved in vardenafil group, with an efficacy rate of 67% as compared with 40% in the sertraline group. The difference was significant between the two groups (P < 0.05). In both of the two groups, a significantly higher rate of PE improvement was found in patients with improved ED than in those without. Only mild side effects were recorded, and none withdrew from the treatment.

CONCLUSIONTo patients with concomitant ED and PE, the key to the treatment is to improve their erectile function, and for this purpose, vardenafil works better than sertraline.

Adult ; Ejaculation ; drug effects ; Erectile Dysfunction ; drug therapy ; Humans ; Imidazoles ; therapeutic use ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Serotonin Uptake Inhibitors ; therapeutic use ; Sertraline ; therapeutic use ; Sulfones ; therapeutic use ; Treatment Outcome ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

Premature ejaculation is a common but incompletely understood male sexual dysfunction. Recent years have witnessed fruitful researches on NO in the mechanism of male ejaculation and successful application of selective PDE5 inhibitor in the treatment of male sexual dysfunction. And now the researches on the etiopathogenesis, mechanism, diagnosis and therapy of premature ejaculation have achieved great development. Selective serotonin re-uptake inhibitors (SSRIs) have been widely applied to clinical practice, but with increasing adverse effects. The purpose of the review is to introduce the updated development of the epidemiology, definition, etiopathogenesis, mechanism and therapy of premature ejaculation, and to provide some reference for the diagnosis and management of the problem.
Adult ; Aged ; Ejaculation ; Humans ; Male ; Middle Aged ; Serotonin Uptake Inhibitors ; therapeutic use ; Sexual Dysfunction, Physiological ; diagnosis ; drug therapy ; epidemiology

Premature ejaculation (PE) is a most common sexual dysfunction, for which dapoxetine, a novel selective serotonin (5-HT) re-uptake inhibitor (SSRI), is the only licensed oral medicine at present. With the advantages of fast absorption, rapid action, on-demand medication, and short half-life time, dapoxetine has been proved by clinical trials to be effective in prolonging the intravaginal ejaculation latency time (IELT) and improving the overall condition of PE patients in various areas and populations. Compared with the traditional SSRIs, dapoxetine has a better safety and tolerability. The most frequently reported dapoxetine-related adverse events include nausea, diarrhea, headache and dizziness, but with very few severe or serious cases.
Benzylamines ; therapeutic use ; Biomedical Research ; Ejaculation ; drug effects ; Humans ; Male ; Naphthalenes ; therapeutic use ; Premature Ejaculation ; drug therapy ; Reaction Time ; drug effects ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

OBJECTIVETo evaluate anti-depressive effects of acupuncture on selective serotonin reuptake inhibitors (SSRIs).

METHODSTotally 60 patients with depression were randomly assigned to the control group (30 cases) and the treatment group (30 cases). All patients took one kind of SSRIs. Those in the treatment group were additionally treated by acupuncture. All were treated for 6 weeks. Patients' efficacies were evaluated with Hamilton Depression Scale (HAMD), Self-rating Depression Scale (SDS), and Eisenberg antidepressant side effects scale (Asberg).

RESULTSCompared with the control group after 6 weeks of treatment, the cured-markedly effective rate was improved by 33.4% in the treatment group (P < 0.05). The HAMD was lower in the treatment group. The tendency of interaction of sleep disorder factor and anxiety/somatization factor was different between at the end of 1-week treatment and at the end of 6-week treatment in the treatment group (P < 0.05). The SDS score decreased at the end of 6-week treatment in the treatment group. The reduction rate was elevated by 19.23% (P < 0.05). By the end of 6-week treatment, the average score of Asberg decreased by 3.77 score in average in the treatment group, while it decreased by 0.07 score in average in the control group (P < 0.05).

CONCLUSIONAcupuncture could effectively improve anti-depressive effects of SSRIs and reduce their adverse reactions.

Acupuncture Therapy ; Adult ; Aged ; Antidepressive Agents ; pharmacology ; therapeutic use ; Depression ; therapy ; Female ; Humans ; Male ; Middle Aged ; Serotonin Uptake Inhibitors ; pharmacology ; therapeutic use ; Treatment Outcome ; Young Adult

Affective Symptoms ; drug therapy ; etiology ; Female ; Fluoxetine ; therapeutic use ; Humans ; MELAS Syndrome ; complications ; psychology ; Middle Aged ; Serotonin Uptake Inhibitors ; therapeutic use ; Stroke ; complications ; psychology

Legalized gambling is a growing industry, and is probably a factor in the presently increasing prevalence of pathological gambling. We present a case of a 36-year-old pathological gambler who was treated with fluvoxamine, a selective serotonin reuptake inhibitor, and who was assessed by functional MRI before and after drug administration. During activation periods, the pathological gambler was shown cards as stimuli, and fMRI results in several brain regions showed differential effects before and after medication and a maintenance period. This case demonstrates that the treatment response to fluvoxamine in a pathological gambler was observed not only by subjective self-report, but also by objective fMRI results. Therefore, fMRI may be a useful tool in the diagnosis and prediction of treatment response in patients afflicted with pathological gambling.
Adult ; Behavior, Addictive/*drug therapy ; Fluvoxamine/*therapeutic use ; *Gambling ; Humans ; Magnetic Resonance Imaging ; Male ; Serotonin Uptake Inhibitors/*therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the clinical value of Paroxetine combined with mid-frequency electrical pulse acupoint stimulation (EPAS) in the treatment of premature ejaculation (PE).

METHODSTotally 69 PE patients were equally assigned to receive oral Paroxetine 20 mg/d, mid-frequency EPAS, or oral Paroxetine 10 mg/d combined with mid-frequency EPAS (P + EPAS) , all for 8 weeks. We obtained the intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE-5) scores of the patients before and after treatment, and compared adverse reactions among the three groups of patients.

RESULTSOne patient of the Paroxetine group gave up treatment because of abdominal pain and nausea. Compared with the baseline, the patients in the Paroxetine, EPAS, and P + EPAS groups all showed markedly increased IELT ([0.92 ± 0.11] vs [4.07 ± 0.11] min, P < 0.01; [0.92 ± 0.12] VS [2.78 ± 0.17] min P < 0.05; [0.91 ± 0.09] vs [5.31 ± 0.13], P < 0.01) and decreased CIPE-5 scores (12.5 ± 3.0 vs 22.0 ± 2.1, P < 0.01; 12.8 ± 2.9 vs 19.5 ± 1.9, P > 0.05; 13.1 ± 2.8 vs 25.2 ± 2.1, P 0.01), with statistically significant differences between the P + EPAS group and the other two (P < 0.05). The total effectiveness rate was 95.7% in the P + EPAS group, remarkably higher than in the Paroxetine (72.7%, P < 0.05) and the EPAS group (47.8, P < 0.01).

CONCLUSIONOral Paroxetine combined with mid-frequency EPAS has a higher safety and efficacy than either Paroxetine or EPAS alone in the treatment of PE.

Acupuncture Points ; Aged ; Combined Modality Therapy ; methods ; Ejaculation ; Electroacupuncture ; methods ; Humans ; Male ; Paroxetine ; therapeutic use ; Premature Ejaculation ; therapy ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

OBJECTIVETo observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.

METHODSForty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine, and the control group (20 patients) treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.

RESULTSHAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05). The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%). No significant difference of TESS scores was found between the two groups.

CONCLUSIONEA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.

Adult ; Combined Modality Therapy ; Depression ; drug therapy ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Paroxetine ; adverse effects ; therapeutic use ; Serotonin Uptake Inhibitors ; adverse effects ; therapeutic use ; Treatment Outcome