Discontinuation of Dapoxetine Treatment in Patients with Premature Ejaculation: A 2-Year Prospective Observational Study

Abstract

Objective: Although dapoxetine is the only oral agent approved for premature ejaculation (PE) and is very effective, its discontinuation rate is high compared to PDE5 inhibitors for ED treatment. We assessed discontinuation rate of dapoxetine in PE and the reasons for discontinuation. Design and Method: The study enrolled 182 patients (mean age 38.2). The PE type (life-long or acquired), self-estimated intravaginal ejaculation latency time (IELT), IIEF-EF questionnaire, and medical history were checked in all patients. The patients were evaluated 1, 3, 6, 12, and 24 months after initiating therapy regarding the treatment status and the reasons for treatment discontinuation. Results: Of the patients, 9.9% were still in treatment after 2 years. The discontinuation rates at 1, 3, 6, 12, and 24 months were 26.4, 35.2, 17.6, 8.2, and 2.7%, respectively. Cumulatively, 79.1% of the patients discontinued the treatment within 6 months. After 12 months, however, the discontinuation rate dropped sharply. The reasons for discontinuation were cost (29.9%), disappointment that PE is not a curable disease and dapoxetine was needed whenever he had sex (25%), side effects (11.6%), low efficacy (9.8%), to seek other treatment options (5.5%), and unknown (18.3%). Patients with acquired PE (vs. life-long), IELT >2 min before treatment, older than 50 years, taking PDE-5 inhibitors, and IIEF-EF <26 tended to discontinue early and had high drop-out rates. Conclusions: Only 9.9% patients continued treatment after 24 months, while 79.1% discontinued within 6 months. The main reasons for discontinuation were not related to its side effects or low efficacy.