Dapoxetine: Hoạt chất ức chất tái hấp thu serotonin dùng để điều trị xuất tính sớm

Priligy is the only approved medication for treating premature ejaculation (PE) in men aged 18 to 64. It belongs to the class of fast-acting, short-term selective serotonin reuptake inhibitors (SSRIs). Dapoxetine mechanism of action involves the inhibition of serotonin reuptake at neural synapses, which in turn enhances dopaminergic and noradrenergic transmissions. This medication is typically taken “on-demand”, 1-3 hours before sexual activity, once daily. It gets absorbed swiftly in the gastrointestinal tract, achieving its highest plasma level roughly 1 hour after taking it.

The determinants of PE are undoubtedly complex and multivariate, with the aetiology of lifelong PE different from that of acquired PE. Our understanding of the neurochemical central control of ejaculation is at best rudimentary although recent imaging and electrophysiological studies have identified increased and decreased neuronal activity in several brain areas during arousal and ejaculation Hyun et al. 2008; McMahon et al. 2004. This definition is supported by evidence from several controlled clinical trials which suggest that 80–90% of men with lifelong PE ejaculate within 60 s and the remaining 10–20% within 2 min (Figure 1) McMahon, 2002; Waldinger et al. 1998a. This definition should form the basis for the official diagnosis of lifelong PE.

• When taken after full elution, 62.5% of patients with LPE, in whom sertraline is satisfactory, reported dapoxetine to be satisfactory, and there were no significant differences between the two groups.
• However, they can cause penile glans numbness and condom use or prior washing off before sexual activity is required to prevent transference of the drug to the vaginal mucosa (14).
• Although daily off-label antidepressant SSRIs are effective treatments for PE, supportive studies are limited by small study populations, infrequent use of PROs of control, distress and satisfaction as outcome measures and inconsistent reporting of known SSRI class-related safety effects.
• In addition to IELT, both doses of dapoxetine improved patient reported outcome measures compared to placebo (96).

الآثار الجانبية لدابوكستين (dapoxetine side effects)

Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) with a short duration of action. Since 2009, dapoxetine received approval for the on-demand treatment of premature ejaculation. Dapoxetine leads to a delay of the ejaculation reflex and extends the IELT (intravaginal ejaculatory latency time).

All four doses of dapoxetine documented statistically significant improvements in IELT over placebo (Table 4). Because of its rapid action and short half-life, the on-demand use of dapoxetine makes it a popular alternative for treating PE (94-97). Several randomized controlled trials (RCTs) demonstrated the efficacy and safety of dapoxetine on more than 6,000 men with PE in over 25 countries (95,97-99) (Table 3). Integrated analysis of these phase III trials of dapoxetine demonstrate a significant increase in geometric mean IELT, from baseline (0.8 min) with 30 mg (2.0 min) and 60 mg (2.3 min) vs. placebo (1.3 min) at 12 weeks (96).

Benefits of Dapox Tablet

Dapoxetine helps in increasing the ejaculation time, thereby improving sexual life. Though side effects are less common with the drug, any uncomfortable effects must be informed to the health care provider at the earliest for better care. It increases the time to ejaculate, and thus reduces the stress you face over how fast you ejaculate and may improve your satisfaction during sexual intercourse. Psychotherapy can be an alternative as well as a method supporting the treatment of PE. The choice of therapy should be discussed with the patient and, if possible, with the partner.

All patients received dapoxetine 30 mg (taken 1–3 hours before sexual intercourse) for 12 weeks, and they were not taking sertraline during the trial. Data about side effects of dapoxetine is based on 4224 patients with premature ejaculation from placebo-controlled studies. Most often, nausea (2.2% of patients) and dizziness (1.2% of patients) led to discontinuation of therapy. This communication will focus on the prevalence, etiology, pathophysiology, and the current treatment options for PE.

The global prevalence of PE is estimated to be between 20% and 40%, making it the most common sexual dysfunction in men. PE causes distress and reduced quality of life for patients and has a negative impact on interpersonal relationships. Historically, it has been treated with cognitive therapy, behavioral methods, and off-label use of selective serotonin reuptake inhibitors usually used to treat depression and other psychological disorders. Dapoxetine is a selective serotonin reuptake inhibitor specifically designed to treat PE. This paper reviews the current evidence for use of dapoxetine in the treatment of PE in adult men. There is substantial evidence that dapoxetine 30 mg or 60 mg taken “on-demand” results in a significant increase in intravaginal ejaculatory latency time when compared with placebo.

At 24 hours following the last dose on day 9, there is 5.5% and 6.6% of peak plasma dapoxetine concentrations left in the blood circulation for the 30 and 60 mg doses, respectively (80). Moreover, co-administration of PDE-5 inhibitors with dapoxetine has no effect on the pharmacokinetics of dapoxetine (81). This favorable pharmacokinetic profile makes dapoxetine the drug of choice for on-demand treatment of PE. The strongest evidence for the use of dapoxetine in adult males with premature ejaculation is for the main disease-oriented outcome of IELT, reported in seven of the nine publications identified in our literature search (see Table 4). Dapoxetine significantly and consistently increased IELT by approximately 3–4 minutes, representing a 3–4-fold increase in IELT.

Furthermore, NO-donator agents diminish the adrenergic response in human seminal vesicles in vitro (Machtens et al 2003). Recently, sildenafil has been documented to exhibit a direct inhibitory action on smooth muscles tone of the human vas deferens, through activation of prejunctional K+ channels (Medina et al 2000). Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine. To review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. P value is based on fold-increase from baseline, not difference from placebo as stated for the other studies.

The dose may be increased to 60 mg (the maximum recommended dose) based on efficacy and tolerability. Each film-coated tablet contains either 30 mg or 60 mg dapoxetine hydrochloride, and may be https://www.infinitypiercing.com.br/blog/2025/01/10/steroids-before-and-after-understanding-the-impact-36/ administered with or without food. Dapoxetine is an effective, safe and well tolerated on-demand treatment for PE and, in the opinion of the author, is likely to fulfil the treatment needs of most patients. Although daily off-label antidepressant SSRIs are effective treatments for PE, supportive studies are limited by small study populations, infrequent use of PROs of control, distress and satisfaction as outcome measures and inconsistent reporting of known SSRI class-related safety effects.