Dapoxetine for Premature Ejaculation Review

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.

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 ejaculationdelay creamssprays 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.

SSRIs Efficacity for PE
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 effective against 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:

  1. 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
  2. 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
  3. 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.
  4. 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
  5. 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.

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Published for Premature Ejaculation Help. All rights reserved ©. Feel free to share or quote this article in part or in its entirety, but please be sure to link back to the original post. Thank you.

Philippe Côté-Léger is the founder of Premature Ejaculation Help, an informative website and blog about Premature Ejaculation. His goal is to help couple around the world to overcome their sexual difficulties and enjoy a thriving sex life.

2 Comments

  1. Mike Petrow
    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

    Reply

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