Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review
Phase III clinical studies of dapoxetine in men with PE indicated that dapoxetine was generally safe and well tolerated with the dosing regimens used (30 mg and 60 mg as required) Buvat et al. 2009; Kaufman et al. 2009; McMahon et al. 2010, 2011; Pryor et al. 2006; Shabsigh et al. 2008. To date, no drug has been specifically approved by the US Food and Drug Administration (FDA) for the treatment of premature ejaculation. However, numerous studies have shown that selective serotonin reuptake inhibitors (SSRIs) and drugs with SSRI-like side effects are safe and effective to treat this condition, and many physicians use these agents for this purpose. Topical desensitizing therapy with local anesthetic agents can also be useful in some men with premature ejaculation.
Uses of Dapox Tablet
- Cialis is primаrily used to treat ereсtile dysfunctiоn (ED) by increasing blood flow tо the penis, resulting in imрroved erections.
- Subjects received a single dose of dapoxetine 30 mg or 60 mg on day 1 (single-dose phase) and on days 4–9 (multiple-dose phase).
- The effects of 30 mg dapoxetine generally last for about 1 to 3 hours after taking the dose.
- In this technique, the female partner slowly begins stimulation of the male but stops as soon as he senses a feeling of excessive excitement that may lead to ejaculatory inevitability.
An analysis of pooled phase 3 data confirms that dapoxetine 30 and 60 mg increased IELT and improved patient reported outcomes (PROs) of control, ejaculation related distress, interpersonal distress and sexual satisfaction, compared to placebo. Efficacy results were similar among each of the individual trials and for a pooled analysis, indicating that dapoxetine is consistently more efficacious than placebo regardless of a subject’s demographic characteristics. Due to the nature of PE, a change in IELT is the only disease-orientated outcome that is regularly measured and reported. Other frequently reported outcomes are necessarily patient-reported outcomes, and these are discussed later.
Premature ejaculation is when a man ejaculates sooner than he or his partner would expect, leading to a dissatisfactory sexual experience. Though less talked about, it is a common condition that most men face at some time in their lives. When premature ejaculation occurs less frequently, it is not a matter of concern. However, medical attention is necessary when it happens every time during sex or masturbation, where ejaculation occurs within less than a minute after penetration. Medicines, counseling, sexual techniques, or a combination of therapies can help delay ejaculation and improve the sexual experience. The recommended starting dose for all patients is 30 mg, taken as needed approximately 1–3 h prior to sexual activity.
The strongest evidence for the use of dapoxetine in adult males with premature ejaculation is for the main disease-oriented outcome of IELT, reported in seven of the nine publications identified in our literature search (see Table 4). Dapoxetine significantly and consistently increased IELT by approximately 3–4 minutes, representing a 3–4-fold increase in IELT. Placebo, in contrast, generally resulted in just a two-fold increase in IELT. The disease-oriented efficacy of dapoxetine has been shown in the studies examined here to be supported by positive effects in all patient-reported outcomes, which together indicate a significant improvement in wellbeing and quality of life. Importantly, clear evidence was found for improvements in interpersonal relationships, suggesting that both sexual partners benefitted from dapoxetine treatment. Snap right here and think about assessment results to find what completely different patients report as recurrence of using Everlong Pill.
Some physicians are comfortable implementing pharmacologic therapy but not behavioral therapy. As with any medical condition, the patient should be offered all available treatment options, and the physician should proceed with referral for any option considered to require more specialized help than the physician can provide. Accordingly, some therapists advise young men to masturbate (or have their partner stimulate them rapidly to climax) 1-2 hours before sexual relations are planned. In an older man, such a strategy may be less effective, because the older man may have difficulty achieving a second erection after his first rapid sexual release.
Adverse effects
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medications for the treatment of a variety of mood disorders such as depression (62). The use of SSRIs to treat PE is based on the observation that delayed ejaculation and anorgasmia are common side effects of this class of drugs (41,63). SSRIs, either alone at low doses or in combination with psychosexual counseling are widely accepted as first line treatments for lifelong PE (14). Men with acquired PE generally receive targeted therapy aimed at resolving the underlying etiology of their PE, either with or without the addition of SSRIs (10). SSRIs act to block the axonal reuptake of serotonin from the synaptic cleft of central serotonergic neurons by 5-HT transporters, which desensitize the 5-HT1A and 5-HT1B receptors (64). The delay in ejaculation can occur within a few days; however, chronic administration for at least 2-3 weeks is necessary to maximize the drugs therapeutic effects (10).
Historically, attempts to explain the aetiology of PE have included a diverse range of biological and psychological theories. Most of these proposed aetiologies https://rhodelhi.com/steroid-39/the-contribution-of-steroids-to-accelerated/ are not evidence based and are speculative at best. The determinants of PE are undoubtedly complex and multivariate, with the aetiology of lifelong PE different from that of acquired PE. Our understanding of the neurochemical central control of ejaculation is at best rudimentary although recent imaging and electrophysiological studies have identified increased and decreased neuronal activity in several brain areas during arousal and ejaculation Hyun et al. 2008; McMahon et al. 2004. From the literature searches, nine publications were identified for inclusion in the following evaluation of the clinical evidence for dapoxetine in the treatment of PE. These comprised three integrated analyses, six randomized placebo-controlled studies (two studies of identical design are only available as an integrated analysis), one subanalysis of two studies, and one long-term extension study.