What is recommended if the initial SSRI is ineffective in treating premature ejaculation (PE)?

Updated: Jan 15, 2019
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

If the initial SSRI fails to help the patient, it is certainly reasonable to try a second agent. However, if the second choice fails, it is not likely that a third choice will offer any benefit. As with treatment for depression, if a patient has been taking the maximal dose of the medication for 6 weeks without showing any improvement, the likelihood that a more prolonged course of therapy with a particular drug would be successful is remote.

There is no reason why pharmacotherapy cannot be combined with behavioral modification therapy, desensitizing creams, or both; the use of several simultaneous treatments can result in additive effects or even synergy. If all treatment fails, then the patient’s only options are as follows:

  • To see a different health care professional, if he wishes

  • To accept his condition as being untreatable with currently available therapeutic options


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