Dapoxetine is an ejaculation-delaying drug effective against premature ejaculation. You can find it under several names such as Priligy and Westoxetin. First developed as an antidepressant, it isn’t used to treat depression because the body evacuates the drug rapidly. However, it’s a good treatment option for premature ejaculation since it allows the ejaculation delay effects of an SSRI without having the drug constantly in your system.
Dapoxetine is the first approved drug for the treatment of premature ejaculation in Europe. Unlike other SSRIs for premature ejaculation, it’s not used off-label. However, it is not yet available in the USA or Canada. Therefore, you shouldn’t look for dapoxetine if you live in the US or in Canada. You should instead speak to your doctors about SSRIs if you’re looking for a drug treatment, or try some over-the-counter topical products. Sertraline, an SSRI similar to dapoxetine can also be prescribed via a telemedicine service in the USA.
A Word of Caution
Before we start, we just want to be clear about one thing. All the drugs listed here are strong medicine and are only available via a doctor’s prescription. Never use a drug for which you do not have a prescription. Your health is not something you want to risk, and taking medication without a professional medical advice poses serious health risks.
If you consider using a drug treatment for premature ejaculation, please consult a physician and respect his instructions. This page’s goal is only to present the options available, but it isn’t a professional medical opinion. I’m not aware of every counter indication those drugs may have, neither your particular health condition. Your doctor is, that’s why he’s the one you should trust.
If you are looking for an over-the-counter product to treat premature ejaculation, delay creams, sprays or condoms could be effective solutions.
How Dapoxetine Works
Dapoxetine works the same way as other SSRIs. It increases the level of serotonin in your body by blocking its reabsorption.
Serotonin is a neurotransmitter that inhibits the ejaculatory reflex. So, if you have a low level of serotonin, you ejaculate quicker. The lack of serotonin is considered as one of the causes of premature ejaculation by some. By increasing your serotonin level, dapoxetine also delays ejaculation.
Dapoxetine Efficacy
Dapoxetine effectively makes you last longer. Since it’s an approved drug to treat PE in several countries, dapoxetine underwent serious clinical trials which proved its efficacity1.
About Efficacy Measure
To measure the efficacy of a premature ejaculation drug, we use the ITEL fold increase. You can read more on how different treatment are compared together here. In short, IELT stands for Intravaginal Ejaculation Latency Time. It’s a stopwatch measure of the intercourse time, from the start of the penetration to the ejaculation. We calculate a couple average IELT by timing all their sexual relations on a specified period.
We can calculate the IELT fold increase like this: (IETL after / IETL before) – IETL before. For example, let’s take a couple that has a 1 min average IELT that increases to 2 min after treatment. It represents a 1-fold increase: (2/1) – 1 = 1. If it increases to 3 min, it’s a 2-fold increase: (3/1) – 1 = 2.
Efficacy of Dapoxetine for Premature Ejaculation
If we compare Dapoxetine with other SSRIs effective against premature ejaculation, we find that it’s less effective than paroxetine, sertraline, and fluoxetine. However, dapoxetine is the only SSRI effective on-demand. Other SSRIs are daily usage drugs.
You can find here a table that summarizes the mean IELT fold increase for several SSRI type1-4.
| SSRI Type | Dose | IELT Increase |
|---|---|---|
| Paroxetine | 10-40 mg/day | 8.8 |
| Sertaline | 25-200 mg/day | 4.1 |
| Fluoxetine | 5-20 mg/day | 3.9 |
| Fluvoxamine | Do not have any ejaculation delay effect | |
| Dapoxetine | 30-60 mg/1-3h before sex | 2.5-3.0 |
Source: Treatment of Premature Ejaculation with Dapoxetine (2013) McMahon Chras G.. Chapter 20 in Premature Ejaculation, from Etiology from diagnosis and treatment, Jannini, Emmanuele, McMahon, Chris G., Waldinger, Marcel D., Springer-Verlag Mailand, 2013 p.256, ISBN 978-88-470-2646-9.
Dapoxetine Usage for Premature Ejaculation
There is two type of drug usage for premature ejaculation: daily and on-demand. On-demand usage drugs are pills that you need to take 2 hours before having sex. However, you have to take daily usage drugs every day and they procure a prolonged effect.
Daily SSRI
Most SSRIs are daily usage drugs. Paroxetine, sertraline, and fluoxetine are all daily drugs and they all show a better efficacy than dapoxetine.
On-Demand SSRI
Dapoxetine is the only on-demand SSRI especially designed to treat PE.
Dapoxetine Side Effect
Just like any other SSRIs, dapoxetine has side effects. However, one of the advantages of an on-demand drug is that its side effects aren’t continuous, but concentrated approximately 1-1.5 hours after usage. The more frequent side effects are nausea, diarrhea, headache, dizziness, insomnia, somnolence, fatigue, and cold1. However, of all the people who suffered from adverse effect, only 3-4% of the subjects report severe or serious side effects1.
Please note that this isn’t a complete list of all dapoxetine potential side effects. For a complete list of all known side effects, please consult a professional medical opinion, like a doctor or a pharmacist.
Dapoxetine Discontinuation Syndrome
Like any other SSRI, if you stop taking dapoxetine abruptly, you can suffer from discontinuation syndrome. However, since dapoxetine is taken on-demand, its discontinuation syndrome is less frequent than with daily SSRI1. Still, if you want to avoid any discomfort, it’s better to talk to your doctor first if you’re going to stop taking dapoxetine.
Wish for Pregnancy
Since we don’t know a lot about SSRIs effect on spermatozoid, some specialists suggest stopping SSRI usage gradually for men who are looking to father a child. Also, because the spermatozoa take some time to regenerate, it’s advised to use a condom for three months after the drug stoppage5.
Sources:
- Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R et al (2006) Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet 368:929–937, Buvat J, Tesfaye F, Rothman M, Rivas DA, Giuliano F (2009) Dapoxetine for the treatment
of premature ejaculation: results from a randomized, double-blind, placebo-controlled phase 3 trial in 22 countries. Eur Urol 55:957–967 Kaufman JM, Rosen RC, Mudumbi RV, Tesfaye F, Hashmonay R, Rivas D (2009) Treatment benefit of dapoxetine for premature ejaculation: results from a placebo-controlled phase III trial. BJU Int 103:651–658, McMahon C, Kim SW, Park NC, Chang CP, Rivas D, Tesfaye F et al (2010) Treatment of premature ejaculation in the Asia-Pacific region: results from a phase III double-blind,parallel-group study of dapoxetine. J Sex Med 7:256–268 - Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B (2004) Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impotence Res 16:369–38, Althof SE, Abdo CHN, Dean J, Hackett G, McCabe M, McMahon CG, Rosen RC, Sadovsky R, Waldinger MD, Becher E, Broderick GA, Buvat J, Goldstein I, El-Meliegy AI, Giuliano F, Hellstrom WJG, Incrocci L, Jannini E, Park K, Parish S, Porst H, Rowland D, Segraves R, Sharlip I, Simonelli C, Tan HM (2010) International society for sexual medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med. 7:2947–2969
- Treatment of Premature Ejaculation with Selective Serotonin Re-Uptake Inhibitors (2013) Waldinger MD. Chapter 19 in Premature Ejaculation, from Etiology from diagnosis and treatment, Jannini, Emmanuele, McMahon, Chris G., Waldinger, Marcel D., Springer-Verlag Mailand, 2013 p.229-240, ISBN 978-88-470-2646-9.
- Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B (1998) Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. J Clin Psychopharmacol 18:274–281, de Jong TR, Snaphaan LJ, Pattij T, Veening JG, Waldinger MD, Cools AR, Olivier B (2006) Effects of chronic treatment with fluvoxamine and paroxetine during adolescence on serotonin-related behavior in adult male rats. Eur Neuropsychopharmacol 16:39–48
- Treatment of Premature Ejaculation with Selective Serotonin Re-Uptake Inhibitors (2013) Waldinger MD. Chapter 19 in Premature Ejaculation, from Etiology from diagnosis and treatment, Jannini, Emmanuele, McMahon, Chris G., Waldinger, Marcel D., Springer-Verlag Mailand, 2013 p.229-240, ISBN 978-88-470-2646-9.
January 1, 2018 @ 10:29 pm
I suffer from premature ejaculation. It’s very hard to cope with. Any help would be appreciated. Thanks Mike Petrow
January 2, 2018 @ 11:42 am
Hi Mike,
First of all, the first thing I would advise is to not stress yourself too much. I know it’s easier said than done, and as a lifelong premature ejaculator myself, I know how PE can have negative consequences in your life. Still, we the right mindset and the right treatment options, we all can achieve a level of ejaculatory control close to average.
For this, I’ll recommend taking the Premature Ejaculation Test to see which type of PE you suffer from. If it’s Acquired PE, you should go see to doctor to screen for any medical causes of your premature ejaculation. If it’s Subjective PE, then I shouldn’t stress about your condition. Some simple premature exercises should help you enough.
If you have Lifelong PE or Variable PE, I would also try the exercises above. If you do not see any progress with the exercises, you can go see a doctor and look for medical treatment. As this article explains, Dapoxetine is an available drug in Europe with a doctor prescription. SSRIs are also an option and can be prescribed off-label in most countries including USA, Canada, and UK. If you’re looking for an over the counter solution, benzocaine cream, benzocaine coated condoms or lidocaine spray are the best products you can try.
Sex therapy can also be an option if you have a hard time coping with PE. A therapist can help you put things in perspective. Also, on our How to Deal with PE page, you can find section that will help you manage your PE if you are in a relationship or if you’re single and you think PE can hurt your chances while dating.