Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment

Waldinger, MD

HERO ID

532861

Reference Type

Journal Article

Year

2005

Language

English

HERO ID 532861
In Press No
Year 2005
Title Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment
Authors Waldinger, MD
Journal World Journal of Urology
Volume 23
Issue 2
Page Numbers 102-108
Abstract The ejaculation distribution theory (EDT) postulates a biological continuum of the intravaginal ejaculation latency time (IELT) in men. Such an continuum has recently been found in two epidemiological stopwatch studies. In addition, a continuum of ejaculation latency time has also been demonstrated in laboratory rats. It is suggested that the invariable parts of ejaculation, i.e. premature and retarded ejaculation are highly influenced by genetic and neurobiological factors. In contrast, superimposed on biological roots, ejaculation of men, in the middle part of the continuum, is probably more easily influenced by environmental and psychological factors. A meta-analysis of 35 daily SSRI and clomipramine treatment studies demonstrated a similar efficacy for paroxetine, clomipramine, sertraline and fluoxetine, with paroxetine exerting the strongest effect on ejaculation. Based on fundamental insights into serotonergic neurotransmission, it is suggested that on-demand conventional SSRI treatment will not lead to similarly impressive ejaculation delay as that found after daily conventional SSRI treatment. Future studies with SSRIs with short half-lives, short T-max and high C-max should elucidate whether these pharmacokinetic properties are able to affect the pharmacodynamics of 5-HT neurons in such a way that immediate clinically relevant ejaculation delay occurs.
Doi 10.1007/s00345-004-0491-z
Url https://www.scopus.com/inward/record.uri?eid=2-s2.0-22944470087&doi=10.1007%2fs00345-004-0491-z&partnerID=40&md5=3c2d92bb3e67d8642387f4d5499c6fe5
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword premature ejaculation; epidemiology; serotonin; dapoxetine; paroxetine; double-blind; sexual-behavior; delayed ejaculation; squeeze technique; male-rat; paroxetine; placebo; antidepressants; clomipramine; fluoxetine
Is Qa No