Dapoxetine is a medication specifically developed to address premature ejaculation (PE) in adult men. It is classified as a selective serotonin reuptake inhibitor (SSRI), though it differs from other SSRIs typically used for depression or anxiety. Dapoxetine’s primary purpose is to help men gain better control over ejaculation timing and prolong sexual activity. It is intended for on-demand use rather than continuous daily treatment.
Understanding Dapoxetine’s Action
Dapoxetine functions by modulating serotonin levels within the brain, a neurotransmitter that influences mood regulation and impulse control, including the ejaculatory reflex. It acts as a selective serotonin reuptake inhibitor (SSRI), meaning it temporarily blocks the reabsorption of serotonin by nerve cells. This action increases the concentration of serotonin in the synaptic cleft, the space between neurons. The increased serotonin activity at postsynaptic receptors subsequently delays the ejaculatory process. Dapoxetine’s influence on specific serotonin receptor subtypes, particularly 5-HT(1A), 5-HT(1B), and 5-HT(2C), is believed to mediate its ejaculatory delay effect. Unlike other SSRIs, dapoxetine is absorbed and eliminated rapidly, making it suitable for its on-demand application for premature ejaculation.
Taking Dapoxetine Correctly
The recommended starting dose is one 30 mg tablet, taken approximately 1 to 3 hours before engaging in sexual activity. It should be swallowed whole with a full glass of water, and it can be taken with or without food. If the initial 30 mg dose proves insufficient and is well-tolerated without significant side effects, a healthcare professional may consider increasing the dose to one 60 mg tablet. It is important not to exceed one tablet within any 24-hour period. Its effects generally last for a few hours.
Potential Side Effects and Safety Considerations
Common side effects include nausea, dizziness, headache, and dry mouth. Some individuals may also experience diarrhea, fatigue, or insomnia. These effects are usually mild and may resolve on their own. However, more concerning side effects, such as fainting or a significant drop in blood pressure (orthostatic hypotension), can occur. It is important to rise slowly from a sitting or lying position to minimize the risk of dizziness or fainting.
Dapoxetine is not suitable for everyone and has several contraindications. It should not be used by men with moderate to severe liver impairment or significant heart conditions, including heart failure, certain conduction abnormalities, or ischemic heart disease. Individuals with a history of dizziness from low blood pressure or fainting episodes should also exercise caution.
Concurrent use with certain medications can be risky. Dapoxetine should not be combined with monoamine oxidase inhibitors (MAOIs), other SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants due to the potential for serotonin syndrome, a serious condition caused by excessive serotonin levels. Potent CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) can increase dapoxetine levels, raising the risk of side effects. Alcohol consumption should be avoided as it can increase the risk of fainting and other adverse effects.
Other Strategies for Premature Ejaculation
Behavioral techniques are often recommended and can be used alone or in conjunction with medication. The “squeeze technique” involves applying pressure to the tip of the penis just before ejaculation to reduce arousal and delay climax. The “start-stop method” involves pausing or reducing sexual stimulation when ejaculation feels imminent, then resuming once the sensation subsides. This helps individuals learn to recognize and control their arousal levels. Pelvic floor exercises, which strengthen the muscles involved in ejaculation, can also improve control.
Psychological counseling, including sex therapy or couples therapy, can address underlying anxiety, stress, or relationship issues contributing to premature ejaculation. These therapies aim to improve communication and provide strategies for managing emotional factors related to sexual performance.
Other pharmacological options include topical anesthetic creams or sprays containing lidocaine or prilocaine, which can be applied to the penis to reduce sensitivity and delay ejaculation.