Dapoxetine

Dapoxetine (known as Priligy) is a selective serotonin reuptake inhibitor (SSRI), but a special one: unlike the classic SSRIs for depression, it is not taken continuously but on demand, one to three hours before sexual activity.

Its target is different from the PDE-5 inhibitors: dapoxetine addresses premature ejaculation, not the erection. The two are sometimes combined because they address different things.

Serotonin is involved in the nervous system's control of the ejaculation reflex; more available serotonin tends to delay it. Dapoxetine briefly raises serotonin availability and so shifts the timing later.

The key is the fast pharmacokinetics: peak after 60 to 90 minutes, half-life only one to two hours. So the effect is fast in and fast out, without the typical chronic SSRI pharmacology.

Dapoxetine is taken as a tablet on demand, about one to three hours before activity.

• Common is 30mg, and 60mg if needed and well tolerated.
• At most once a day.
• A glass of water with it helps against possible nausea. Do not combine with alcohol.

Dapoxetine is well studied clinically. An integrated analysis of two large randomised phase 3 trials (Pryor, 2006) showed that on-demand dapoxetine is effective and generally well tolerated in premature ejaculation. On this basis it was introduced as a specific agent for PE.

The study with a link is in the source block below.

The most common side effect is nausea, clearly dose-dependent. On top come dizziness, headache and occasionally diarrhoea. Because dapoxetine is serotonergic, caution is needed when combining with other serotonin-active substances (other SSRIs, certain migraine or pain medications, MDMA).

The most important point is the serotonergic interaction: combining with other serotonin-active compounds can lead to a serotonin excess and should be avoided. Anyone taking antidepressants or other central medications should clear it with a doctor first. Also be careful with circulatory sensitivity (dapoxetine can cause dizziness on standing up).

Store the tablets dry, at room temperature and protected from light, out of reach of children. Keep the original packaging closed and mind the expiry date.