An Open Labelled Randomized Clinical Trial of Fluoxetine Versus Dapoxetine Treatment among Men with Premature Ejaculation and its Effect on Marital Satisfaction

  Premature ejaculation (PE) reduces sexual satisfaction and quality of life. Both SSRI Fluoxetine and Dapoxetine have been used in the treatment of PE. Fluoxetine is used as off-label treatment meanwhile Dapoxetine is the first SSRI specifically designed for PE with short half-life and few side effects. Objectives: To compare the PE symptoms and marital satisfaction score between Fluoxetine and Dapoxetine groups. Materials and method: In this clinical trial, 44 participants aged between 18 and 64 with PEDT score of ≥9 from the Primary Care clinic of Hospital USM, Kelantan were recruited and randomized into two groups; Fluoxetine Group(FG) and Dapoxetine Group(DG). They were prescribed with either daily oral Fluoxetine 20mg or Dapoxetine 30mg on demand twice weekly for 8 weeks. PE symptoms were measured using the Premature Ejaculation Diagnostics Tool(PEDT) score and marital satisfaction score were measured using the Dyadic Satisfaction-Dyadic Adjustment Scale(DS-DAS) score. Measurements were made at baseline and at the 8thweek(post intervention). Results: In FG and DG, 22 and 21 participants completed the study, respectively. PEDT scores reduced significantly within both groups[from 11.41 to 5.45(P<0.001) within FG and from 13.43 to 3.10(P<0.001) within the DG]. At the 8thweek follow-up, PEDT scores was observed to be were lower in DG(6.03 vs. 2.49,P<0.001) after adjustment of the baseline PEDT score. Significantly increased DS-DAS scores were observed in both groups [from 34.50 to 40.68(P<0.001) within FG and from 36.57 to 44.33,(P<0.001) within DG] with no significant difference in DS-DAS scores at the end of study(41.13 vs. 43.86,P=0.055) after adjustment of the baseline DS-DAS score. Conclusion: Reduction in PE symptoms was observed for both groups. At 8 weeks, PE symptoms among participants on Dapoxetine were significantly lower compared to the participants on Fluoxetine at 8 weeks. Treatment of PE with either Fluoxetine or Dapoxetine reduces symptoms of PE and improves marital satisfaction.