Can paroxetine be used for premature ejaculation?

Paroxetine, a medication commonly known as an antidepressant, is also used off-label to treat premature ejaculation (PE). This article explores how paroxetine works for PE, how long it takes to be effective, and potential side effects.

What Is Paroxetine and How Does It Help Premature Ejaculation?

Paroxetine belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). While it is primarily prescribed for depression and anxiety, research has shown that paroxetine can significantly increase the time it takes to ejaculate (intravaginal ejaculatory latency time, or IELT) in men with PE. It is thought to do this by increasing the amount of a chemical called serotonin (also known as 5-hydroxytryptamine, or 5-HT).

Studies and systematic reviews have found that paroxetine is more effective than placebo, fluoxetine, and escitalopram in delaying ejaculation, with most men experiencing a notable improvement in control and satisfaction. However, it is important to note that this use is not officially approved in many countries, and treatment should always be supervised by a healthcare professional.

How Long Does Paroxetine Take to Work for Premature Ejaculation?

Paroxetine does not work instantly. When taken daily, improvements in ejaculation delay can be noticed within a few days, but the maximum effect is usually achieved after 1–2 weeks of consistent use. Clinical studies report that after 4 weeks of daily paroxetine, many men experience a significant increase in IELT—from less than a minute to several minutes.

If paroxetine is taken only as needed (episodically), it should be taken 3–4 hours before sexual activity, but this method is generally less effective than daily dosing, and the onset of action is slower compared to some other treatments.

When to Take Paroxetine for Premature Ejaculation

There are two main approaches outlined by clinical guidelines for the dosing of paroxetine for PE:

• Daily Dosing: The most effective method is taking paroxetine every day, usually at a dose of 10–20 mg. This maintains a steady level of the drug in the body and provides the greatest benefit for most men.
• On-Demand (Episodic) Dosing: Some men may be advised to take paroxetine only when needed, at a dose of 20 mg, taken 3–4 hours before planned intercourse. This approach may be suitable for those who do not wish to take medication daily.

How to Take Paroxetine for Premature Ejaculation

Treatment often begins with 10–20 mg daily. The dose may be adjusted based on response and tolerability. Take the tablet at the same time each day if using daily dosing. For on-demand use, take the dose 3–4 hours before sexual activity. Most studies recommend trying the medication for at least 4 weeks to assess its full effect.

What Are the Side Effects of Paroxetine?

While paroxetine can be effective for treating premature ejaculation, it may cause side effects in some men. Most side effects are mild and temporary, but a small percentage of users experience more persistent or bothersome symptoms. If side effects become an issue, your healthcare provider may consider switching to the on-demand dosing approach.

Common side effects of paroxetine include:

• Decreased libido (reduced sexual desire)
• Difficulty achieving orgasm or inhibited orgasm
• Ejaculatory disturbance, including delayed ejaculation (which is the intended effect for PE treatment)
• Erectile dysfunction
• Weakness
• Nausea and gastrointestinal upset
• Constipation
• Headache
• Dry mouth
• Sweating
• Drowsiness
• Trouble sleeping (insomnia)

Important Considerations

The benefits of paroxetine for PE typically disappear soon after stopping the medication, with symptoms often returning within a few weeks. Paroxetine manages symptoms but does not cure PE. Long-term use may be necessary for ongoing benefit. Always seek medical advice before starting paroxetine for PE, as it may interact with other medications and is not suitable for everyone.

Summary

Paroxetine is a well-studied, effective option for many men with premature ejaculation, especially when taken daily. However, it is not a cure and should be used under medical supervision to ensure safety and effectiveness.

See also:

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