Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
J Sex Med. 2009 Oct;6(10):2868-77. doi: 10.1111/j.1743-6109.2009.01404.x. Epub 2009 Jul 28.
Selective serotonin reuptake inhibitors are the most widely used agents for delaying ejaculation in patients with premature ejaculation (PE).
The aim of this study was to assess the acceptance of and the discontinuation rate from paroxetine treatment in patients with lifelong PE.
We analyzed the acceptance of and discontinuation rates of 93 consecutive potent patients (mean age, 37.6 years) seeking medical treatment for lifelong PE. The patients were assessed with detailed medical and sexual history, self-reported intravaginal ejaculatory latency time, self-administered International Index of Erectile Function, complete physical examination, and the Meares-Stamey test. The patients received a paroxetine prescription (10 mg daily for 21 days and then 20 mg as needed) for the first 3 months. Thereafter, the patients could either stay with the same on-demand treatment or take paroxetine 10 mg daily for 3 months. The patients were evaluated at 3 and 6 months, and requested to complete multiple-choice global assessment questions regarding specific reasons for eventual therapy discontinuation.
The primary end point was acceptance and discontinuation rates for paroxetine treatment in patients seeking medical treatment for lifelong PE. The secondary end point was the reasons for nonacceptance of treatment or discontinuation.
Twenty-eight (30.10%) patients decided not to start paroxetine. Fear of using an "antidepressant drug" was the main reason (42.9%) for treatment nonacceptance. Twenty (30.8%) patients who initiated therapy eventually discontinued it. Treatment effect below expectations was the main reason of treatment dropout (75%) during the first 3 months, followed by temporary loss of interest in sex because of relationship issues (15%) and side effects (10%). Of the patients who continued treatment, 77.8% preferred daily paroxetine, while 22.2% continued as-needed therapy.
Thirty percent of lifelong PE patients seeking medical treatment for complaints of early ejaculation freely decided not to start any paroxetine treatment, and roughly 30% of patients who started therapy eventually discontinued it.
选择性 5-羟色胺再摄取抑制剂是治疗早泄（PE）患者延迟射精最常用的药物。
本研究旨在评估接受度和帕罗西汀治疗终身性 PE 患者的停药率。
我们分析了 93 例连续就诊的有生育能力的患者（平均年龄 37.6 岁）对帕罗西汀治疗的接受度和停药率。患者接受详细的医学和性史、自我报告的阴道内射精潜伏期、自我管理的国际勃起功能指数、全面体检和 Meares-Stamey 试验评估。患者在前 3 个月接受帕罗西汀处方（10mg 每日，连续 21 天，然后按需服用 20mg）。此后，患者可以继续按需服用相同剂量的药物，也可以服用帕罗西汀 10mg 每日，连续 3 个月。患者在 3 个月和 6 个月时进行评估，并要求完成多项选择的全球评估问题，以了解最终停药的具体原因。
主要终点是寻求治疗终身性 PE 的患者对帕罗西汀治疗的接受度和停药率。次要终点是不接受治疗或停药的原因。
28 例（30.10%）患者决定不开始服用帕罗西汀。担心使用“抗抑郁药”是不接受治疗的主要原因（42.9%）。20 例（30.8%）开始治疗的患者最终停药。治疗效果低于预期是前 3 个月停药的主要原因（75%），其次是因关系问题暂时对性生活失去兴趣（15%）和副作用（10%）。继续治疗的患者中，77.8%更喜欢每日服用帕罗西汀，而 22.2%继续按需治疗。
30%寻求治疗因早泄而投诉的终身性 PE 患者自行决定不开始任何帕罗西汀治疗，约 30%开始治疗的患者最终停药。
