Drugs that increase serotonin signalling in the brain slow ejaculation and have been used successfully to treat premature ejaculation. These include selective serotonin reuptake inhibitors (SSRIs), such as paroxetine or dapoxetine, as well as clomipramine. Ejaculatory delay typically begins within a week of beginning medication. The treatments increase the ejaculatory delay to 6–20 times greater than before medication. Men often report satisfaction with treatment by medication, and many discontinue it within a year. However, SSRIs can cause various types of sexual dysfunction such as anorgasmia, erectile dysfunction, and diminished libido.
Dapoxetine is a short-acting SSRI which appears to work when taken as needed for premature ejaculation. It is generally well tolerated. Tramadol, an atypical oral analgesic, appears to be effective.
