Abdollahian Ebrahim, Javanbakht Arash, Javidi Kamran, Samari Ali Akbar, Shakiba Mansur, Sargolzaee Mohammad Reza
Ibn E Sina Hospital of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran.
Am J Addict. 2006 Jan-Feb;15(1):100-4. doi: 10.1080/10550490500419151.
Premature ejaculation is a common symptom that can provoke relapse in formerly opioid-dependent men after detoxification. The purpose of this study was to compare the efficacy of clomipramine and fluoxetine for the treatment of premature ejaculation in formerly opioid-dependent men after detoxification. Sixty opium-detoxified men with A & B DSM-IV diagnostic criteria for premature ejaculation participated in a prospective two-week descriptive inferential clinical trial after a two-week washout period. The subjects did not consume any other medications but naltrexone for maintenance of an opium-free state. The subjects were randomly divided into two groups of thirty subjects, one group received fluoxetine (10 mg/d for the first and 20 mg/d for the second week), and the other received clomipramine (25 mg/d for the first and 50 mg/d for the second week). Twenty five subjects did not continue the treatment and were lost to follow-up. The severity of the premature ejaculation was graded regarding the subjects' report in weeks 0, 1, and 2. Mann Whitney-U and Wilcoxon non-parametric tests were used for statistical analysis. Fluoxetine (10 mg/d then 20 mg/d) and clomipramine (25 mg/d then 50 mg/d) were both effective in the treatment of premature ejaculation and did not show any difference in efficacy. The severity of premature ejaculation did not show any relation to the subjects' age, education level, opioid type, or route of abuse. Fluoxetine and clomipramine both can be equally used in the treatment of premature ejaculation following opioid detoxification, depending on their side effects and other symptoms in the subjects.
早泄是一种常见症状，可使既往阿片类药物依赖者在戒毒后病情复发。本研究的目的是比较氯米帕明和氟西汀治疗既往阿片类药物依赖者戒毒后早泄的疗效。60名符合《精神疾病诊断与统计手册》第四版（DSM-IV）早泄诊断标准A和B的戒毒男性，在经过两周的洗脱期后，参加了一项为期两周的前瞻性描述性推断性临床试验。受试者除纳曲酮外未服用任何其他药物以维持无阿片状态。受试者被随机分为两组，每组30人，一组服用氟西汀（第一周10毫克/天，第二周20毫克/天），另一组服用氯米帕明（第一周25毫克/天，第二周50毫克/天）。25名受试者未继续治疗并失访。根据受试者在第0、1和2周的报告对早泄严重程度进行分级。采用曼-惠特尼U检验和威尔科克森非参数检验进行统计分析。氟西汀（先10毫克/天，后20毫克/天）和氯米帕明（先25毫克/天，后50毫克/天）在治疗早泄方面均有效，且疗效无差异。早泄严重程度与受试者年龄、教育水平、阿片类型或滥用途径无关。根据受试者的副作用和其他症状，氟西汀和氯米帕明均可同等用于治疗阿片类药物戒毒后的早泄。
