Fluoxetine effective against premature ejaculation, but compliance remains poor

Despite the efficacy of fluoxetine in producing clinical improvements in premature ejaculation, adherence beyond 6 months remains low, a recent study has shown.

The study included 130 men (mean age, 31±14 years) with primary premature ejaculation, who used fluoxetine and had at least 12 months of follow-up data. Self- and partner-reported variables were used to assess the efficacy of the intervention. Medication adherence was also set as an outcome.

At baseline, 94 percent reported poor ejaculatory control and 72 percent had partners who were under moderate or severe distress due to the premature ejaculation; almost half (47 percent) of the participating men had the similar distress.

After 3 months, 76 percent reported improvements of at least 1 minute in the intravaginal ejaculatory latency time (IELT), while 64 percent, 38 percent and 11 percent reported improvements of at least 2, 3 and 5 minutes, respectively. Continued use of fluoxetine at 6 and 12 months led to sustained IELT improvements of at least 1 minute in 72 percent and 69 percent, respectively.

Significantly fewer men self-reported having poor ejaculatory control at the same time point (94 percent to 42 percent; p<0.01). Similarly, severe personal (45 percent to 11 percent) and partner (70 percent to 27 percent; p<0.01 for both) distress rates also dropped significantly.

Despite such improvements, adherence was low. At 3 months, 11 percent of the participants had dropped out of the treatment. This shot up to 56 percent and further to 72 percent by months 6 and 12, respectively.