CLOMIPRAMINE AND SEXUAL FUNCTION IN MEN WITH PREMATURE EJACULATION AND CONTROLS

Purpose: We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls. Ma terials and Methods: The study included 8 patients with primary premat ure ejaculation, 6 with premature ejaculation and erectile dysfunction , and 8 controls. A prospective, double-blind, placebo controlled, cro ssover design was used that included 2, 3-week periods with clomiprami ne and placebo. During treatment phases subjects took either 25 mg. cl omipramine or placebo as needed, that is 12 to 24 hours before anticip ated sexual activity (coitus or masturbation). Subjects also visited t he laboratory during these phases for evaluation of sexual response us ing visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phas es. Results: Clomipramine significantly increased the latency to ejacu lation during sexual activity (coitus or masturbation) from approximat ely 2 to 8 minutes in men with primary premature ejaculation. There we re no significant effects in controls and men with premature ejaculati on plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejacul atory response with clomipramine therapy. In these men clomipramine al so resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects. Co nclusions: Clomipramine (25 mg. as needed) effectively increases ejacu latory latency in men with primary premature ejaculation, while treatm ent is not effective in those with premature ejaculation and erectile dysfunction.