Altuğ TUNCEL, Yılmaz ASLAN, M. Murad BAŞAR, Ali ATAN

Efficacy of Clomipramine, Sertraline and Terazosin Treatments in Premature Ejaculation

Aim: To compare the efficacy of oral clomipramine, sertraline and terazosin to placebo in premature ejaculation. Materials and Methods: A total of 90 patients aged from 20 to 58 years were enrolled in this study. Patients were randomized into 4 groups. Group 1 (n: 22) took placebo and served as controls. Group 2 (n: 23) patients took 25 mg clomipramine HCl nightly; Group 3 (n: 20) 50 mg sertraline nightly; and Group 4 (n: 25) 5 mg terazosin nightly. The medications were used for two months. After 8 sexual attempts, the patients' clinical responses were assessed using the patient self-description method. Clinical responses were classified as ``no change´´, ``improvemen´´ and ``under contro´´. Success was described as improvement + under control. Results: Success rates were 36.3% in Group 1, 91.3% in Group 2, 90% in Group 3 and 76% in Group 4. Although the efficacy of each medical treatment was superior to placebo (P = 0.001), no significant difference in efficacy was found between the medical treatment groups (P = 0.537). Conclusions: Clomipramine, sertraline and terazosin are more efficient than placebo. No significant difference was observed in terms of efficacy among these three medical treatments.

Anahtar Kelimeler:

Premature ejaculation, treatment, antidepressant, alpha blocker

Efficacy of Clomipramine, Sertraline and Terazosin Treatments in Premature Ejaculation

Keywords:

Premature ejaculation, treatment, antidepressant, alpha blocker,

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Spiess WF, Geer JH, O’Donohue WT. Premature ejaculation: investigation of factors in ejaculatory latency. J Abnorm Psychol 1984; 93: 242-5.
Strassberg DS, Mahoney JM, Schaugaard M, Hale VE. The role of anxiety in premature ejaculation: a psychophysiological model. Arch Sex Behav 1990; 19: 251-7.
Colpi GM, Fanciullacci F, Beretta G, Negri L, Zanollo A. Evoked sacral potentials in subjects with true premature ejaculation. Andrologia 1986; 18: 583-6.
Jannini EA, Simonelli C, Lenzi A. Disorders of ejaculation. J Endocrinol Invest 2002; 25: 1006-19.
Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 2004; 16: 369-81.
Schuster TG, Ohl DA. Diagnosis and treatment of ejaculatory dysfunction. Urol Clin North Am 2002; 29: 939-48.
Lorrain DS, Matuszewich L, Friedman RD, Hull EM. Extracellular serotonin in the lateral hypothalamic area is increased during the postejaculatory interval and impairs copulation in male rats. J Neurosci 1997; 17: 9361-6.
Waldinger MD, Olivier B. Selective serotonin reuptake inhibitor- induced sexual dysfunction. Clinical and research considerations. Int Clin Psychopharmacol 1998; 13 (Suppl. 6): S27-S33.
Berendsen H, Broekkamp C. Behavioural evidence for functional interactions between 5-HT receptor sub-types in rats and mice. Br J Pharmacol 1990; 101: 667-73.
Yells DP, Prendergast MA, Hendricks SE, Nakamura M. Fluoxetine induced inhibition of male rat copulatory behavior: modification by lesions of the nucleus paragigantocellularis. Pharmacol Biochem Behav 1994; 49: 121-7.
Kim SW, Lee SH, Paick J-S. In vivo rat model to measure hypogastric nerve-stimulation-induced seminal vesicle and vasal pressure responses simultaneously. Int J Impot Res 2004; 16: 427-32.
Segraves RT, Saran A, Segraves K, Maguire E. Clomipramine versus placebo in the treatment of premature ejaculation: a pilot study. J Sex Marital Ther 1993; 19: 198-200.
Haensel SM, Rowland DL, Kallan KT, Slob AK. Clomipramine and sexual function in men with premature ejaculation and controls. J Urol 1996; 156: 1310-5.
McMahon CG, Ramin S. Pharmacological treatment of premature ejaculation. Curr Opin Urol 1999; 9: 553-61.
Mendels J, Camera A, Sikes C. Sertraline treatment for premature ejaculation. J Clin Psychopharmacol 1995; 15: 341-6.
Balbay MD, Yildiz M, Salvarci A, Ozsan O, Ozbek E. Treatment of premature ejaculation with sertraline. Int Urol Nephrol 1998; 30: 81-3.
McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study. J Urol 1998; 159: 1935-8.
Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: a double- blind, placebo-controlled study. J Urol 1998; 159: 425-7.
Teng CM, Guh JH, Ko FN. Functional identification of alpha- adrenoreceptor subtypes in human prostate: comparison with those in rat vas deferens and spleen. Eur J Pharmacol 1994; 265: 61-6.
Pupo AS. Functional effects of castration on alpha1- adrenoreceptors in rat vas deferens. Eur J Pharmacol 1998; 351: 217-23.
Silva MA, Megale A, Avellar MCW, Porto CS. Expression and pharmacological characterization of alpha1-adrenoreceptors in rat seminal vesicle. Eur J Pharmacol 1999; 381: 141-9.
Debruyne FM, Van der Poel HG. Clinical experience in Europe with uroselective alpha 1-antagonists. Eur Urol 1999; 36 (Suppl 1): 54-8.