Brief Answer:
Yes medicines are there, clomipramine and paroxetine

Detailed Answer:
Hello,

Thanks for writing to us. From PE I understand that you are talking about early ejaculation.

According to the latest diagnostic criteria by DSM 5, premature ejaculation (PE) should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.

Treatment for PE:

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required. No major side effect of it.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.

I also want to mention non pharmacological approach to deal with PE.

Behavioral approaches are as follows for your information:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Kegel exercise also helps in some cases. You can learn the same from internet.

3. Sex counselling of your sexual behavior and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex (at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
clomipramine is recommended in your case

Detailed Answer:
Hi,

Thanks for follow up.

Depoxetine is prescription drug and available in 30 mg dose and under doctor's guidance you can take it as long as needed until you improved and can last long without drug. You can modify the dose according to response and treating doctor's instructions.

In your case I surely recommend clomipramine as it is required in very low dose and no significant side effects with that. If I were your treating doctor I surely would like to prescribe clomipramine not paroxetine.

Please consult doctor to get prescription.

Feel free to discuss further.

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Brief Answer:
Yes it may help

Detailed Answer:
Hi,

Thanks for follow up.

Clomipramine is good drug for obsessions but in that case it is needed in dose more than 50 mg.

Your symptoms of nervousness and swallowing are anxiety symptoms. This is likely due to social anxiety. I recommend taking propranolol before any presentation or in situation when you are going to face such anxiety likely.

Clomipramine in 10 mg dose may help in your problem but in my opinion propranolol is better alternative.

If your social anxiety problem is since long, I recommend consulting psychiatrist for evaluation. Psychotherapy like Cognitive therapy and specific anti anxiety medicines can treat your problem permanently.


Take care.


If still any query there, you are welcome.

If no more query, you can close the discussion and give ratings and feedback.

In future if you wish you can contact me directly with this link

Http ://bit.ly/drchintansolanki

with same amount of fees and 3 follow up questions.

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Brief Answer:
yes it will be helpful in night fall also

Detailed Answer:
Hi,

Yes taking clomipramine or paroxetine at night time can help in night fall and prevent ejaculation in dreams.

http://bit.ly/drchintansolanki

Take care dear.

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