Effectiveness and Safety of Fluoxetine for Premature Ejaculation: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Cong ¹ , ZHAO Wendi ¹ ,  ZHONG Zhaohui ²

1. Department of Medical Science, Chongqing Medical University, Chongqing 400016, China;2. Department of Public Health Management, Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

ZHONG Zhaohui, Email: zzhlxb@qq.com

Keywords：

Fluoxetine; Selective serotonin reuptake inhibitor; Premature ejaculation; Intravaginal ejaculatory latency time; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20120232

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To systematically evaluate the effectiveness and safety of fluoxetine in treating premature ejaculation (PE).
Methods 　All randomized controlled trials (RCTs) on fluoxetine treating PE published from July 1996 to May 2012 were collected in the following databases: MEDLINE, EMbase, PubMed, Ovid, The Cochrane Central Register of Controlled Trials, CBM and CKNI. According to the inclusion and exclusion criteria, literature screening, data extraction and quality assessment were conducted independently by two reviewers. Then meta-analysis was performed using RevMan 5.0 software.
Results 　A total of 6 RCTs involving 221 patients were included finally. The results of meta-analysis showed that, as for effectiveness, there was no significant difference in the intravaginal ejaculatory latency time (IELT) between the two groups before the treatment (WMD=–0.21, 95%CI −4.79 to 4.37, P=0.93), but the IELT of the fluoxetine group was obviously longer than that of the control group after the treatment, with a significant difference (WMD=134.54, 95%CI 79.78 to 189.30, P lt;0.000 01). The results of sensitivity analysis indicated that the IELT of the fluoxetine group was longer than that of the control group, with a significant difference (WMD=155.19, 95%CI 130.64 to 179.75, P lt;0.000 01). As for safety, the fluoxetine group was higher in the incidence of adverse reaction than the control group, with a significant difference (OR=5.49, 95%CI 2.43 to 12.38, P lt;0.000 1).
Conclusion 　Current evidence indicates that fluoxetine can improve the symptoms of PE patients, obviously prolong the IELT, and improve the quality of sexual life; and it is tolerable to patients with mild adverse reactions and is suitable for long-term intake. For the limited quantity of the included studies, we herein believe that, to obtain more evidence, it is necessary to further confirm the diagnosis and therapeutic criteria of PE, to design and conduct more multicenter and large scale clinical studies by adopting the internationally recognized indexes, and to perform a long-term follow-up．

Citation： WANG Cong,ZHAO Wendi,ZHONG Zhaohui. Effectiveness and Safety of Fluoxetine for Premature Ejaculation: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(12): 1510-1515. doi: 10.7507/1672-2531.20120232 Copy

1.	Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med, 2005, 2(3): 358-367.
2.	Symonds T, Roblin D, Hart K, et al. How does premature ejaculation impact a man’s life? J Sex Marital Ther, 2003, 29(5): 361-370.
3.	Sotomayor M. The burden of premature ejaculation: the patient’s perspective. J Sex Med, 2005, 2 (Suppl 2): 110-114.
4.	Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation:a double-blind, randonfised, placebo controlled study. Am J Psychiat, 1994, 151(9): 1377-1379.
5.	Kara H, Aydin S, Yücel M, et al. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J Urol, 1996, 156(5): 1631-1632.
6.	Mattos RM, Lucon AM, Srougi M. Tadalafil and fluoxetine in premature ejaculation: prospective, randomized, double-blind, placebo-controlled study. Urol Int, 2008, 80(2): 162-165.
7.	Waldinger MD. The neurobiological approach to premature ejaculation. J Urol, 2002, 168(6): 2359-2362.
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(2): 425-427.
9.	Yilmaz U, Tatlişen A, Turan H, et al. The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation. J Urol Jan, 1999, 161(1): 107-111.
10.	潘寿华, 谢立平. 氟西汀治疗早泄的疗效观察. 临床泌尿外科杂志, 2004, 19(7): 400-401.
11.	Haensel SM, Klem TM, Hop WC, et al. Fluoxetine and Premature Ejaculation: A Double-Blind, Crossover, Placebo-Controlled Study. J Clin Psychopharm, 1998, 18(1):72-77.
12.	Wang WF, Chang L, Minhas S, et al. Selective serotonin reuptake inhibitors in the treatment of premature ejaculation. Chinese Med J, 2007, 120 (11): 1000-1006.
13.	Mousatizadeh K, Ghafourifar P, Sadeghi-nejad H. Calcium channel blocking activity of thiordazine, clomipramine and fluoxetine inisolated vas deferens: A relarive potency measurement study. J Urol, 2002, 168(6): 2716-2719.
14.	Seo KK, Kim SC, Lee MY. Comparison of peripheral inhibitory effects of clomipramine with selective serotonin reuptake inhibitors on contraction of vas deferens: In vitro and in vivo studies. J Urol, 2001, 165(6): 2110-2114.
15.	孙中义, 李彦锋, 周波, 等. 盐酸氟西汀每日用药与按需给药在早泄治疗中的比较研究. 中华男科学杂志, 2010, 24 (3): 50, 51, 59.
16.	Gurkan L, Oommen M, Wayne JG. et al. Premature ejaculation: current and future treatments. Asina J Androl, 2008, 10(1): 102-109.
17.	Manasia P, Pomerol J, Ribè N, et al. Comparison of The Efficacy and Safety of 90 mg Versus 20 mg Fluoxetine in the Treatment of Premature Ejaculation. J Urol, 2003, 170(1): 164-165.

1. Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med, 2005, 2(3): 358-367.
2. Symonds T, Roblin D, Hart K, et al. How does premature ejaculation impact a man’s life? J Sex Marital Ther, 2003, 29(5): 361-370.
3. Sotomayor M. The burden of premature ejaculation: the patient’s perspective. J Sex Med, 2005, 2 (Suppl 2): 110-114.
4. Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation:a double-blind, randonfised, placebo controlled study. Am J Psychiat, 1994, 151(9): 1377-1379.
5. Kara H, Aydin S, Yücel M, et al. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J Urol, 1996, 156(5): 1631-1632.
6. Mattos RM, Lucon AM, Srougi M. Tadalafil and fluoxetine in premature ejaculation: prospective, randomized, double-blind, placebo-controlled study. Urol Int, 2008, 80(2): 162-165.
7. Waldinger MD. The neurobiological approach to premature ejaculation. J Urol, 2002, 168(6): 2359-2362.
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(2): 425-427.
9. Yilmaz U, Tatlişen A, Turan H, et al. The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation. J Urol Jan, 1999, 161(1): 107-111.
10. 潘寿华, 谢立平. 氟西汀治疗早泄的疗效观察. 临床泌尿外科杂志, 2004, 19(7): 400-401.
11. Haensel SM, Klem TM, Hop WC, et al. Fluoxetine and Premature Ejaculation: A Double-Blind, Crossover, Placebo-Controlled Study. J Clin Psychopharm, 1998, 18(1):72-77.
12. Wang WF, Chang L, Minhas S, et al. Selective serotonin reuptake inhibitors in the treatment of premature ejaculation. Chinese Med J, 2007, 120 (11): 1000-1006.
13. Mousatizadeh K, Ghafourifar P, Sadeghi-nejad H. Calcium channel blocking activity of thiordazine, clomipramine and fluoxetine inisolated vas deferens: A relarive potency measurement study. J Urol, 2002, 168(6): 2716-2719.
14. Seo KK, Kim SC, Lee MY. Comparison of peripheral inhibitory effects of clomipramine with selective serotonin reuptake inhibitors on contraction of vas deferens: In vitro and in vivo studies. J Urol, 2001, 165(6): 2110-2114.
15. 孙中义, 李彦锋, 周波, 等. 盐酸氟西汀每日用药与按需给药在早泄治疗中的比较研究. 中华男科学杂志, 2010, 24 (3): 50, 51, 59.
16. Gurkan L, Oommen M, Wayne JG. et al. Premature ejaculation: current and future treatments. Asina J Androl, 2008, 10(1): 102-109.
17. Manasia P, Pomerol J, Ribè N, et al. Comparison of The Efficacy and Safety of 90 mg Versus 20 mg Fluoxetine in the Treatment of Premature Ejaculation. J Urol, 2003, 170(1): 164-165.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Fluoxetine for Premature Ejaculation: A Meta-Analysis

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