Recently, Mr. He, who visited the clinic, asked: I ejaculate too quickly every time I have sex, and my wife has a lot of complaints about it. This problem has been occurring for more than a year, and I have tried some methods, such as topical application of medicine, but they cannot prolong the ejaculation time. There is information online that depression medication can treat premature ejaculation, does it really work? I believe many male friends are curious about this question raised by Mr. He. Today, we will talk about why antidepressants are unique in the treatment of premature ejaculation. The definition of premature ejaculation Premature ejaculation is a common sexual dysfunctional disease in men, which is an ejaculatory disorder with a prevalence of about 20-30%. 2008, the International Society of Sexual Medicine proposed an evidence-based definition of premature ejaculation: ejaculation almost always occurs within 1 min after vaginal insertion; inability to actively prolong ejaculation time; and causes negative negative emotions, such as worry, pain, frustration, etc. Etiology of premature ejaculation The etiology of premature ejaculation is still controversial, and it is generally accepted that its occurrence is a multifactorial one, which is related to psychological, environmental, endocrine, and neurobiological factors. A large part of it is attributed to psychological causes, which manifest themselves mainly as anxiety. It has been reported that patients with primary premature ejaculation are not only due to psychological causes, but most importantly, the excitability of the dorsal penile nerve, especially the sensory nerve excitability of the penile head, is higher than normal in patients. It is also related to the stimulation of inflammation, prepuce, circumcision, excessive masturbation, and neurological diseases. In short, the occurrence of premature ejaculation is a result of the combined action of multiple factors. Premature ejaculation treatment Because the cause of premature ejaculation is still unclear, treatment methods such as psychological intervention, behavioral therapy, and surgical treatment are not as effective as they should be, and their use is limited by the lack of research evidence. A large number of clinical studies have shown that among the current treatments for premature ejaculation, selective 5-hydroxytryptamine reuptake inhibitors (SSRIs) (essentially antidepressants) have largely achieved the purpose of clinical treatment and are widely used. The mechanism of SSRIs for premature ejaculation: Studies have confirmed that there is a class of substances called 5-hydroxytryptamine in the human body, which can accelerate the ejaculation process, so it is conceived to suppress the effect of 5-hydroxytryptamine to delay the ejaculation time. SSRIs are used in the treatment of depression, some patients have adverse effects affecting sexual function such as delayed ejaculation and delayed orgasm, the incidence of which is 50%-64%, therefore, the use of their treatment side effects of depression can be achieved to inhibit ejaculation to treat premature ejaculation. In general, the application of such drugs can delay the ejaculation time by 2-5 minutes. The representative drugs are sertraline and dapoxetine. Sertraline: The common adverse reactions are fatigue, dizziness, drowsiness, insomnia, nausea, vomiting, dry mouth, diarrhea and other symptoms of the nervous system and digestive system. Dapoxetine: It is a new SSRIs preparation with rapid absorption and metabolism. 30 mg of dapoxetine can be taken orally and the blood concentration reaches the highest value after 60-80 minutes. What is the appropriate dose of antidepressants? The dose of antidepressants for premature ejaculation is generally lower than the dose of drugs for anxiety and depression, and generally half or regular therapeutic doses are used, gradually increasing from small doses. How long does it take for antidepressants to treat premature ejaculation? In some patients, premature ejaculation is completely cured after a short period of medication and no further medication is needed. In some patients, the ejaculatory latency is shortened again within a short period of time after stopping the medication, or even returns to the original level, which indicates that continuous medication is needed to achieve long-term prolonged ejaculation. Dr. Yuan suggests that sertraline is generally used continuously for three months and then slowly reduced at the end before stopping the medication. Until a more satisfactory treatment for premature ejaculation is available, antidepressants are still the easiest and most effective way to treat premature ejaculation despite certain problems, such as drug side effects and slow onset of action. Note: Antidepressants are prescription drugs and must be used under the supervision of a doctor. Secondly, because of its side effects such as dizziness, it is best not to drive a car or work at heights and other activities with some risk when you start taking the medication.