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Antidepressants can delay ejaculation LOUANNE COLE, Ph.D.EXAMINER MOVIE CRITIC Wednesday, March 22, 1995 Q: I've heard that antidepressant medications can lead to men having difficulty in reaching orgasm. But I've also heard that it can help men who do want to delay their ejaculations. What do you know about this? A: There have been a few studies that show positive effects from some antidepressants for men who usually ejaculate quickly. None of the research that I'm aware of was conducted with a large number of people and some of it reports on only one man being treated by his physician. Nevertheless, this information may be helpful to some readers who've experienced sexual changes they could not otherwise explain. In one case in Italy in 1993, P. Stratta and some colleagues were treating a mild form of depression. They had not set out to cause a change in their patient's sexual functioning. Instead, much to everyone's surprise, they and their patient reported a sexual change. The patient, a 31-year-old man, reported that his long-standing quick ejaculation (less than 30 seconds of intercourse thrusting before ejaculating) was totally alleviated when treated with the antidepressant fluoxetine (Prozac). After six months of treatment, the patient stopped taking the drug. His depressive symptoms did not return, but nine weeks later he experienced a partial return of the quick ejaculation. He resumed taking a low dose and a week later his sexual functioning returned to its improved state. When these same doctors later treated another 35-year-old man who ejaculated quickly, they decided to try fluoxetine again. After adjusting the dosage twice, this man reported improved control of his ejaculation timing. He later reduced his dose and maintained his ability to last longer. In 1994, T.N. Wise, M.D., reported similar results using the antidepressant sertraline (Zoloft) with a 43-year-old man who had ejaculated rapidly since he first became sexually active. After four weeks of treatment, he was able to be stimulated for about six to 10 minutes before ejaculating. In 1993, R.T. Segraves and colleagues reported in the Journal of Sex and Marital Therapy on a study they had conducted using another antidepressant, clomipramine(Anafranil), or a placebo with 20 men who'd had long-standing rapid ejaculation difficulties. The mentook either the drug or a placebo over the course of weeks during which they had 10 intercourse experiences. Neither the men nor the researchers knew which men had which pill during the time of the study. The men on the clomipramine had significant improvement and lasted on average about six minutes, while the men onthe placebo averaged about 51 seconds. The men taking the clomipramine also reported significant improvement in their libido, erections, ejaculation timing and quality, and overall satisfaction with sex. The men on the placebo did not report any such changes. As you mentioned, there can be side effects that interfere with sexual functioning from using antidepressants. And, while slowing down ejaculation sounds like a great idea to some men, others who find it difficult to reach orgasm wouldn't like this at all. Sometimes changing to a different antidepressant will return the prior ease of orgasm, but this isn't always the case. If you or someone you know would like to last longer during sexual stimulation, I would consider these types of medications only after giving therapy a serious try. Of all the sexual concerns men bring to therapy, slowing down ejaculation is among the easiest to achieve. Antidepressants are just one example of drugs with fascinating sexual implications. For thousands of years, people have been using drugs for their hoped-for sexual effects, often without realizing their dangers. Readers should be very careful to get expert medical advice before risking a surprising or even harmful sexual effect from drugs. If you'd like to know about other drugs that can have positive sexual effects or how street drugs andmedications affect your sexuality, call Louanne Cole's "Sex Matters" information line at 1-900-773-9463. Anytime after the tone press 26 or 54. The cost is $1 per minute (first 30 seconds free). You must use a touch-tonephone and be at least 18. Cole is a board-certified San Francisco sex therapist. Send your questions to: Sex Matters, Style, San Francisco Examiner, P.O. Box 7260, San Francisco, 94120, or you can send e-mail to: lcolenetcom.com. 1995 Louanne Cole.ejaculation 03/22/95 11:29 PST John Cottingham NEW ADDRESS: [log in to unmask]