ABSTRACT
PURPOSE: Pharmacotherapy using selective serotonin reuptake inhibitors(SSRls) for men with primary premature ejaculation(PE) is promising. Specially, a strategy taking a pill "as needed" may offer an attractive option. To investigate the possibility of self therapy, patients treated for PE with sertraline "as needed" basis were evaluated. MATERIALS AND METHODS: Since 1996 we have treated 24 males with sertraline "as needed" basis for primary PE. We chose sertraline among SSRIs because alarge dose need not to be divided and peak plasma levels occurring 4-8 hours after oral administration makes 5 p.m. suitable for the time of administration. Five p.m. is the time the ordinary men usually fix their evening schedule including intercourses. Each patient was started on 50mg qd for 2 weeks and then the dose was adjusted to 50 or 100mg only on the day of intercourse. RESULTS: After 6 weeks, 18 men continued to take medication and 6 had dropped out. Of 18 men, mean ejaculation latency were 23 +/-19sec before treatment, 5.9 +/-4.2min after 2wks 50mg qd, 5.1 +/-3.8min after 2wks 50/100mg pm and 4.5 +/-2.7min after 4wks 50/100mg prn and mean sexual satisfaction scores ('5"=extremely satisfied, "0"=extremely unsatisfied) of men were 0.8 +/-0.8 before treatment, 3.8 +/-1.2 after 2wks 50mg qd, 3.4 +/-1.0 after 2wks 50/100mg pm and 3.2 +/-0.7 after 4wks 50/100mg pm. And mean sexual satisfaction scores of partners were 1.1 +/-0.7 before treatment, 3.2 +/-1.6 after 2wks 50mg qd,3.1 +/-1.4 after 2wks 50/100mg pm and 3.3 +/-1.2 after 4wks 50/100mg pm. Side effects were intermittent excessive delay in 1 patient, fatigue in 2 patients, numbness in 1 patient. CONCLUSIONS: If our results were supported by additional clinical long term study, self therapy with sertraline given pm at 5 pm in treatment of PE could be as attractive as self injection therapy in the treatment of erectile dysfunction.