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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > paxil lexapro
Expert: Dr Alan Galbraith
Date: 4/21/2008
Subject: paxil lexapro
Question
Sir,
Is paxil, sertraline lexapro similar in efficacy as far as PE is concerned. will be obliged to receive your answer.What is the correct dosage and timing for taking and whether require to be taken on the day of coitus or on regular basis
Answer
Dear Harsvadan
I have appended the recommended details of both drugs in the treatment of PE. You should be able to understand and see what is best. If you have any queries get back to me. The article (slighly edited by me)is by:
Author: Mark Jeffrey Noble, MD, Consulting Staff, Urologic Institute, Cleveland Clinic Foundation
Coauthor(s): Milton Lakin, MD, Head, Section of Medical Urology, Urological Institute, Cleveland Clinic
Drug Name Sertraline (Zoloft)
Description Potent SSRI used to treat premature ejaculation. Improvement may not be evident until at least 3 wk following initiation of treatment. If no benefit with respect to premature ejaculation after 6 wk or if adverse effects become troublesome, discontinue in favour of alternative treatment.
Adult Dose 50 mg PO 2-12 h before sexual relations; alternatively, 50 mg/d PO; gradually titrate to response; not to exceed 200 mg/d
Contraindications Documented hypersensitivity; concomitant MAOIs or use within 14 d
Interactions Increases toxicity of MAOIs, diazepam, tolbutamide, and warfarin; additive CNS effects with alcohol, antidepressants, opioid analgesics, sedatives, and hypnotics; suspension contains alcohol and, therefore, is contraindicated in patients taking disulfiram (Antabuse)
Precautions Caution in recent MI or unstable heart disease; hyponatraemia; although minimal adverse anticholinergic effects (compared with TCAs), use with caution in glaucoma, bladder outlet obstruction, chronic constipation, and other conditions in which adverse anticholinergic effects may exacerbate symptoms; caution in patients with moderate-to-severe renal or hepatic impairment, because of excessive blood level accumulation, adjust dose accordingly; does not impair motor or cognitive ability with respect to performance of complex tasks, nor does it cause somnolence, but any drug affecting the CNS may cause drowsiness, and driving and performance of other tasks requiring alertness and concentration should be avoided; seizures are rare, use with caution in pre-existing seizure disorder; when used for premature ejaculation (off-label), patients with clinical depression should be treated by a mental health care professional, potential for depressed patients to commit suicide; priapism has been (rarely) reported
Drug Name Paroxetine (Paxil)
Description Potent SSRI antidepressant used to treat premature ejaculation. Improvement may not be evident until at least 3 wk following initiation of treatment. If no benefit (with respect to premature ejaculation) after 6 wk or adverse effects become troublesome, medication should be discontinued in favour of an alternative treatment.
Adult Dose 20 mg PO 2-12 h before sexual relations; alternatively, 20 mg/d PO, gradually titrate to response; not to exceed 40 mg/d
Contraindications Documented hypersensitivity; concomitant MAOIs or use within 14 d
Interactions Phenobarbital and phenytoin decrease effects; alcohol, cimetidine, sertraline, phenothiazines, and warfarin increase toxicity; additive CNS depressant effects with other antidepressants, opioid analgesics, sedatives, and hypnotics; increases toxicity of MAOIs
Precautions Caution in recent MI or unstable heart disease; hyponatraemia; although minimal adverse anticholinergic effects (compared with TCAs), use with caution in glaucoma, bladder outlet obstruction, chronic constipation, and other conditions in which adverse anticholinergic effects may exacerbate symptoms; also caution in moderate-to-severe renal or hepatic impairment, because of excessive blood level accumulation (adjust dose accordingly); does not impair motor or cognitive ability with respect to performance of complex tasks, nor does it cause somnolence, but any drug affecting the CNS may cause drowsiness, and driving and performance of other tasks requiring alertness and concentration should be avoided; seizures are rare; caution in pre-existing seizure disorder; when used for premature ejaculation (off-label), patients with clinical depression should be treated by a mental health care professional; potential for depressed patients to commit suicide; priapism has been (rarely) reported.
Regards
Alan Galbraith
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