In the 1990s, when people began taking anti-depressants in the form of selective serotonin reuptake inhibitors (SSRIs), an interesting side effect was noticed: delayed or inability to reach orgasm in both men and women. Numerous studies ensued and the relationship between increased levels of serotonin and delayed orgasm is well documented, if still not well understood.
Since the early 2000s, doctors have been prescribing men with (off-label) these SSRI anti-depressants for premature ejaculation. The efficacy is general quite good. The major downside is that these medications are usually taken daily for sufficient efficacy. Furthermore, the side effects are significant, often including headaches, nausea, dry mouth and, ironically, loss of libido.
The most commonly prescribed SSRIs for depression are also the most commonly prescribed for Premature Ejaculation as well: Paxil, Zoloft, Lexapro and Prozac. A look at multiple studies suggest that Paxil has the best average effectiveness for increasing ejaculation time, followed by Zoloft and Prozac (nearly similar) with Lexapro not included in enough studies to provide any guidance. Papers written about the various studies of Anti-depressants for premature ejaculation suggest that they do not meet normal scientific standards of so patients should not draw conclusions from this web page. Consult your doctor for advice.
Often, the ability of a patient to tolerate side effects typically determines which SSRI will ultimately be used. Sometimes patients will try different SSRIs in order to determine the drug that best meets his combination of efficacy and tolerable side effects. Many men give up on SSRI anti-depressants for premature ejaculation because of the side effects. Many men are turning to safe, effective, easy-to-use, over-the-counter topical agents for the treatment of premature ejaculation.
In limited studies, episodic use of SSRIs such as Paxil, Zoloft and Prozac have shown some effectiveness. However, one SSRI in particular is getting all the attention for on-demand use for premature ejaculation and that is dapoxetine. Although generally lower than a daily dose, side effects remain and issue for on-demand use. As a result, topicals continue to gain popularity in the marketplace.