Kim S C, Seo K K
Department of Urology, College of Medicine, Chung-Ang University, Seoul, Korea.
J Urol. 1998 Feb;159(2):425-7. doi: 10.1016/s0022-5347(01)63940-5.
We compared the efficacy and safety of fluoxetine, sertraline, clomipramine and placebo for the oral pharmacotherapy of premature ejaculation.
The study included 36 men (mean age 44 years) who had intravaginal ejaculation latency of less than 2 minutes. Patients took each of 3 drugs and the placebo consecutively during a 4-week period per each agent. Efficacy and side effects data were obtained by a self-reported patient questionnaire that rated intravaginal ejaculation latency, sexual satisfaction of patient and partner, and possible side effects.
After 4 weeks of treatment with placebo, fluoxetine, sertraline and clomipramine the mean intravaginal ejaculation latency time was significantly increased from 46 seconds to 2.27 minutes, 2.30 minutes, 4.27 minutes and 5.75 minutes, respectively (all p <0.01). However, treatment with clomipramine or sertraline caused a greater increase in mean intravaginal ejaculation latency time than fluoxetine or placebo (p <0.01). Patient sexual satisfaction rate after treatment with clomipramine was significantly higher (p <0.05) than with sertraline, fluoxetine or placebo. Partner sexual satisfaction rate was also higher with clomipramine than with sertraline or fluoxetine but no statistical difference was found. The incidence of side effects with clomipramine was significantly higher (p <0.05) compared to that of fluoxetine, sertraline and placebo, while no significant difference among sertraline, fluoxetine and placebo was noted.
In men with premature ejaculation clomipramine was the most useful drug in terms of efficacy. Treatment with sertraline was nearly as effective and had a lower incidence of side effects.
我们比较了氟西汀、舍曲林、氯米帕明和安慰剂口服治疗早泄的疗效和安全性。
该研究纳入了36名男性（平均年龄44岁），其阴道内射精潜伏期少于2分钟。患者在每种药物为期4周的疗程中依次服用3种药物和安慰剂。疗效和副作用数据通过患者自我报告问卷获得，该问卷对阴道内射精潜伏期、患者及其伴侣的性满意度以及可能的副作用进行评分。
在接受安慰剂、氟西汀、舍曲林和氯米帕明治疗4周后，平均阴道内射精潜伏期分别从46秒显著增加至2.27分钟、2.30分钟、4.27分钟和5.75分钟（均p<0.01）。然而，氯米帕明或舍曲林治疗导致的平均阴道内射精潜伏期增加幅度大于氟西汀或安慰剂（p<0.01）。氯米帕明治疗后的患者性满意度显著高于舍曲林、氟西汀或安慰剂（p<0.05）。氯米帕明治疗后的伴侣性满意度也高于舍曲林或氟西汀，但未发现统计学差异。氯米帕明的副作用发生率显著高于氟西汀、舍曲林和安慰剂（p<0.05），而舍曲林、氟西汀和安慰剂之间未发现显著差异。
对于早泄男性，就疗效而言氯米帕明是最有效的药物。舍曲林治疗效果相近且副作用发生率较低。
