Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis.

Abstract

OBJECTIVE:

To evaluate the efficacy and safety of combination therapy with selective serotonin reuptake inhibitors (SSRIs) and phosphodiesterase-5 (PDE-5) inhibitors for the treatment of premature ejaculation (PE).

METHODS:

A systematic search of EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews was undertaken to identify articles that referred to the use of a combination of SSRIs and PDE-5 inhibitors for the treatment of PE. A meta-analysis of these clinical studies was performed. The post-treatment intravaginal ejaculatory latency time (IELT) and adverse events (AEs) were used in this meta-analysis.

RESULTS:

Six publications involving 971 patients were included in the meta-analysis. In the analysis, we found significantly improved IELT in the combination use group compared with the use of SSRIs (mean differences [MD], 1.01; 95% confidence interval [CI], 0.61-1.41; P <.01) or PDE-5 inhibitors alone (MD, 1.11; 95% CI, 0.79-1.43; P <.01) for PE whether or not these patients suffered from erectile dysfunction. Combined treatment was more efficacious than use of PDE-5 inhibitors alone on sexual satisfaction. Although the occurrence of drug-related AEs in the combination use group was higher than that in the use of SSRIs or PDE-5 inhibitors alone group (37.5% vs 25.63%, P <.01), the most common AEs were mild and tolerable.

CONCLUSION:

The combined use of SSRIs and PDE-5 inhibitors provided additive favorable effects in men with PE compared with SSRIs or PDE-5 inhibitors monotherapy and was generally well tolerated.

• Authors: Yunjin Bai, Chunxiao Pu, Ping Han, Jinhong Li, Haichao Yuan, Yin Tang, Xiaoming Wang, Qiang Wei
• Journal: Urology (Urology) Vol. 86 Issue 4 Pg. 758-64 (Oct 2015) ISSN: 1527-9995 [Electronic] United States
• PMID: 26247816 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Serotonin Uptake Inhibitors
• Cyclic Nucleotide Phosphodiesterases, Type 5

Topics

• Cyclic Nucleotide Phosphodiesterases, Type 5 (therapeutic use)
• Drug Therapy, Combination
• Ejaculation (drug effects)
• Humans
• Male
• Premature Ejaculation (drug therapy, physiopathology)
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Treatment Outcome