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Reference Number and entry criteria Intervention Duration Age Outcomes Results Adverse effects Quality
                 
Taken before sexual activity            
Segraves et al, 1993 USA 29 men <1 minute or before 8 penile-vaginal strokes Clomipramine 25 mg 6 hours before coitus parallel group 10 coital experiences 47 ± 10.2 placebo 45 ± 7.5 clomipramine Men achieving at least 2 minutes intravaginal latency Intravaginal latency 6.1 minutes clomipramine 0.9 minutes placebo 2/10 erectile difficulties with clomipramine r = 1 db = 2 w = 0
Haensel et al, 1996 USA and Holland 8 men premature ejaculation 6 men with erectile dysfunction and premature ejaculation 8 controls Placebo or 25 mg clomipramine 12 to 24 hours before sexual activity cross-over Two 3-week periods 42 (range 31 to 62) 41 (26 to 52) 41 (26 to 52) Intravaginal latency plus others Intravaginal latency increased from 2 minutes on placebo to 8 minutes with clomipramine in men with premature ejaculation, no change in men with additional erectile dysfunction (about 2 minutes) and increased latency in normal controls from 9 to 11 minute No ejaculation failures noted r = 1 db = 2 w = 1
Biri et al, 1998 Turkey 37 men latency <1 minute Sertraline 50 mg or placebo in the evening parallel group 4 weeks 31 (range 21 to 54) Intravaginal latency Median intravaginal latency 0.7 minutes baseline 1.9 minutes placebo 5.4 minutes sertraline No ejaculation failures noted r = 1 db = 2 w = 1
Strassberg et al, 1999 USA and Holland 23 premature ejaculation <2 minutes 11 control subjects Clomipramine 50 mg or placebo 4-6 hours before sexual activity cross-over Two 2-week periods 46 (range 21 to 73) Intravaginal latency Mean intravaginal latency 0.9 minutes on placebo 3.8 minutes on clomipramine Control latency was 8 minutes increased to 11 minutes on clomipramine in 4 subjects No ejaculation failures noted r = 1 db = 2 w = 1
McMahon & Touma, 1999 study 1 26 men with intravaginal latency <1 minute Paroxetine 20 mg or placebo 4-6 hours before sexual activity cross-over Two 4-week periods with 3 week washout 40 (range 19 to 55) Intravaginal latency and coitus frequency Median intravaginal latency 0.3 minutes baseline 0.5 minutes placebo 3.2 minutes paroxetine No ejaculation failures noted r = 1 db = 0 w = 0
McMahon & Touma, 1999 study 2 Australia 42 men with intravaginal latency <1 minute Paroxetine 10 mg daily for 2 weeks then 20 mg as needed 4-6 hours before sexual activity for 4 weeks or placebo in a similar schedule cross-over Two 7-week periods with 3 week washout 41 (range 20 to 51) Intravaginal latency and coitus frequency Median intravaginal latency 0.5 minutes baseline 0.8 minutes placebo 6.0 minutes paroxetine 3 ejaculation failures with paroxetine r = 1 db = 0 w = 0
                 
Daily dosing              
Waldinger et al, 1994 Holland 17 men with intravaginal latency <2 minutes in more than 50% coital attempts Paroxetine or placebo 20 mg daily for 1 week, then 40 mg daily for 5 weeks parallel group 6 weeks 40 (range 24 to 48) Latency time Paroxetine (n=6) latency 10 minutes (5-20) 6/6 >5 min Placebo (n=8) latency 0.25 minutes (0-2) 0/8 >2 min No significant differences r = 1 db = 2 w = 1
Mendels et al, 1995 USA 52 men with intravaginal latency <1 minute in more than 50% coital attempts Sertraline or placebo 50-200 mg daily titrated over 3 weeks parallel group 10 weeks Range 25 to 52 years Intravaginal latency plus others Mean intravaginal latency at endpoint 5.4 minutes sertraline 1.8 minutes placebo Ejaculation failure 5/26 sertraline 0/26 placebo r = 2 db = 2 w = 1
Althof et al, 1995 USA 15 men with self-reported mean time to ejaculation <4 minutes Placebo, 25 mg or 50 mg clomipramine daily cross-over Sufficient for at least 5 occasions of intercourse 38 (range 23 to 56) Intravaginal latency plus others Mean intravaginal latency 1.3 minutes at baseline 3.4 clomipramine 25 mg 7.0 clomipramine 50 mg No ejaculation failures noted r = 1 db = 1 w = 1
Kara et al, 1996 Turkey 17 men with intravaginal latency <2 minutes in more than 50% coital attempts Placebo or fluoxetine 20 mg daily for 1 week, then 40 mg daily parallel group 4 weeks 32 (range 15 to 50 years) all married Intravaginal latency Mean pre-treatment intravaginal latency was 0.5 minutes. After 4 weeks treatment it was 3 minutes with fluoxetine and 1 minute in the placebo group. None mentioned r = 1 db = 1 w = 0
Waldinger et al, 1997 Holland 34 men with primary premature ejaculation with intravaginal latency <1 minute Paroxetine 20 mg or 40 mg daily parallel group 8 weeks 44 (range 23 to 57) Intravaginal latency Median intravaginal latency 0.2 minutes (0-0.5) baseline 5.0 minutes (0.2 to 30) 8 weeks on 20 mg 9.0 minutes (1 to 20) 8 weeks on 40 mg Ejaculatory failure 2/17 20 mg 4/17 40 mg r = 1 db = 2 w = 1
McMahon, 1998 Australia 37 men with latency <1 minute Sertraline or placebo 50 mg daily cross-over Two 4-week periods with 4 week washout 41 (range 19 to 70) Intravaginal latency and coitus frequency Median intravaginal latency 0.6 minutes baseline 1.0 minutes placebo 3.2 minutes sertraline 2/37 ejaculatory failures r = 1 db = 2 w = 1
Kim & Seo, 1998 Korea 36 men with latency <2 minutes Fluoxetine 40 mg Sertraline 100 mg Clomipramine 50 mg placebo cross-over Four 4-week periods with 1 week washout between 44 (range 30 to 60) Intravaginal latency Median intravaginal latency after 4 weeks 0.8 minutes baseline 2.3 minutes placebo 2.3 minutes fluoxetine 4.3 minutes sertraline 5.8 minutes clomipramine No ejaculation failures noted r = 0 db = 2 w = 1 note: does not state randomised, but implied in text