Nawaz Dr. Faisal, Williams Dr. Simon

(221) ON-DEMAND PAROXETINE FOR PREMATURE EJACULATION - SYSTEMATIC REVIEW AND META-ANALYSIS

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives This review aims to compare the efficacy of On-demand Paroxetine to on-demand Dapoxetine and Placebo for the treatment of Premature Ejaculation. Review question In patients with premature ejaculation, does on-demand Paroxetine increase the Intravaginal ejaculatory latency time compared to on-demand Dapoxetine therapy? Methods Electronic databases were systematically searched to identify the eligible Randomized Controlled Trials, comparing on-demand Paroxetine to Dapoxetine or placebo, following the Cochrane Collaboration methodology. Non-randomized trials were excluded. The Protocol for this systematic review was prospectively registered on PROSPERO - International Prospective Register of Systematic Reviews with the reference number CRD42022316352. Results Highly sensitive search strategies were designed following the PRISMA-S guidelines to search the MEDLINE, Cochrane CENTRAL, EMBASE, PsycINFO, and other bibliographic databases. Subject terms (MeSH) "Premature Ejaculation", "Paroxetine", "Dapoxetine", and "on-demand" were adapted to each database for a comprehensive literature search. Results are reported in line with PRISMA guidelines. 1171 abstracts were identified for screening by two independent reviewers using the Covidence software. Full-text screening of the 30 records was performed. The meta-analysis included nine eligible randomized controlled trials, recruiting a total of 721 participants. Meta-analysis was performed using the Cochrane Collaboration's Review manager software. Conclusions Meta-analysis of the included studies favored on-demand Paroxetine over Dapoxetine; however, the IELT improvement was not statistically significant with the on-demand Paroxetine. There was a high degree of heterogeneity among the included trials. On-demand Paroxetine does not significantly prolong the IELT compared to the on-demand Dapoxetine and Placebo. Significant heterogeneity and inconsistencies were found among the included studies. The certainty of the evidence of study outcomes was affected mainly by the study limitations, imprecision, and small sample size. A well-designed, large RCT is required to provide further evidence to support this hypothesis. Conflicts of Interest Nothing to declare.

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