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Sertraline Treatment for Premature Ejaculation

Premature ejaculation is one of the most common sexual complaints, affecting up to 30% of men. Both animal and human studies suggest that serotonin plays a primary role in controlling ejaculation. This randomized placebo-controlled study examined the effect of the selective serotonin reuptake inhibitor (SSRI) sertraline for treating premature ejaculation.

Researchers randomized 52 heterosexual males with steady partners and self-described premature ejaculation to receive either sertraline (50 to 200 mg) or placebo for eight weeks. Patients with scores of 14 or more on the Hamilton Depression Scale (Ham-D) were excluded. Patient diaries and patient and partner interviews were used to monitor latency to ejaculation, number of episodes of premature ejaculation, frequency of successful intercourse attempts, and sexual satisfaction.

The effects of sertraline were already apparent by week four. After eight weeks of treatment, men who received sertraline had a significant increase in time to ejaculation (3.6 vs. 1.2 minutes) and number of successful intercourse attempts (1.7 vs. 0.4) when compared with placebo-recipients, even after controlling for baseline Ham-D scores. Five sertraline-treated patients (20%) reported failure to ejaculate on at least one occasion and one patient reported impotence.

Comment: Treatment of premature ejaculation has focused primarily on emotional factors and retraining of sexual behavior. This study suggests that sertraline is effective and is consistent with previous controlled studies that have documented the efficacy of both clomipramine and paroxetine in the treatment of premature ejaculation. Therefore, it appears that biological factors may sometimes play a role in premature ejaculation and that SSRI pharmacotherapy may effectively correct the problem in nondepressed patients.

— P Roy-Byrne

Published in Journal Watch Psychiatry December 1, 1995

Citation(s):

Mendels J et al. Sertraline treatment for premature ejaculation. J Clin Psychopharmacol 1995 15 341-346.

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