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All men were either married or in a stable relationship. Sixty-four out of ninety-four men Group A were initially treated with paroxetine hydrochloride 20 mg administered once daily. Those men who responded with improved ejaculatory control within four weeks, were then treated with 'on-demand' paroxetine hydrochloride 20 mg administered h prior to planned intercourse. The remaining 33 out of 94 men Group B were initially treated with 'on-demand' paroxetine hydrochloride 20 mg administered h prior to planned intercourse. In group A after four weeks of daily administration of paroxetine, the mean ELT was 4. Fifty-three out of sixty-one men in group A regarded their ejaculatory control as improved and were then treated with 'on-demand' paroxetine, achieving an ELT of 3.
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Antidepressant-associated sexual dysfunction: impact, effects, and treatment

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Antidepressant-associated sexual dysfunction: impact, effects, and treatment

Resulting sexual dysfunction can impair quality of life and intimate relationships and discourage patients from taking antidepressants Box 1 , 2. Although most reports have focused on SSRIs, all antidepressant classes have been associated with sexual dysfunction, with prevalence likely influenced by differences in neurotransmitter modulation Table 2. A recent study reported similarly high rates with mirtazapine, but its small sample size limits conclusions about side effect prevalence with this drug. Clomipramine appears to have the highest rates of sexual dysfunction—particularly anorgasmia—probably because it inhibits the serotonin transporter more than do other TCAs. MAOIs directly increase serotonergic neurotransmission, and their substantial alpha-adrenergic antagonist effects may also produce sexual side effects. Waiting for symptoms to subside may be appropriate, as anorgasmia caused by MAOIs may remit spontaneously.
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What’s the best drug treatment for premature ejaculation?

The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women.
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In addition to asking about your sex life, your doctor will ask about your health history and might do a physical exam. If you have both premature ejaculation and trouble getting or maintaining an erection, your doctor might order blood tests to check your male hormone testosterone levels or other tests. In some cases, your doctor might suggest that you go to a urologist or a mental health professional who specializes in sexual dysfunction. Common treatment options for premature ejaculation include behavioral techniques, topical anesthetics, medications and counseling. Keep in mind that it might take time to find the treatment or combination of treatments that will work for you.
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