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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical treatment of depression or anxiety with selective serotonin reuptake inhibitors (SSRIs) often results in delayed ejaculation or anorgasmia. Co-treatment with subtype-selective serotonin receptor antagonists may alter the timing of onset of action and potentiate or reduce sexual side effects. Sexual behavior in male Sprague-Dawley rats was examined after acute administration of the SSRI, paroxetine and the serotonin1A antagonist, WAY-100,635. Acute administration of paroxetine alone did not alter male ejaculatory behavior. However, administration of paroxetine plus WAY-100,635 resulted in a significant delay in mounting behavior and increased the time to ejaculation. Simultaneous administration of paroxetine and WAY-100,635 produced a greater delay in initiation of mounting behavior and ejaculation compared to sequential administration of paroxetine followed by WAY-100,635. The differential effect on sexual behavior or addition of specific serotonin receptor antagonists may be relevant for clinical treatment therapies of premature ejaculation.
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PMID:Differential effects of simultaneous or sequential administration of paroxetine and WAY-100,635 on ejaculatory behavior. 1625 17

Premature ejaculation (PE) remains an underdetected and under-treated condition, despite the advances in available treatment options. Men with PE often feel stigmatized by the condition and embarrassment is a key barrier to discussing the problem with healthcare professionals. Men with PE perceive themselves as having little control over ejaculation and this lack of control is mirrored in diminished satisfaction with sexual intercourse. The burden of PE is both emotional and physical. Premature ejaculation is associated with low self-esteem, anxiety, and feelings of shame and inferiority. In some studies there is an association with depression. Premature ejaculation places a significant burden on the patient-partner relationship and there is evidence to suggest that there is a higher prevalence of female sexual dysfunction associated with PE. Patients with PE often view the condition as purely psychological or as a problem that will resolve with time and many are unaware that medical treatment could be of benefit. This endorses the particularly important role of healthcare professionals in recognizing the barriers to patient diagnosis and promoting the view that PE is not only a common but also a treatable medical condition.
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PMID:The burden of premature ejaculation: the patient's perspective. 1642 97

Male sexual dysfunction-a term that is commonly used to refer to erectile dysfunction, premature ejaculation, decreased libido and impaired orgasm-is the primary complaint encountered by many urologists. Despite the high prevalence and bothersome nature of these complaints, they are frequently neglected in clinical practice. This paper highlights clinical situations in which urologists should systematically evaluate male sexual functioning. These include men who present with several common urologic disorders, such as pelvic trauma, malignancies, and lower urinary tract symptoms associated with benign prostatic hyperplasia, neurologic disorders and infertility. Studies have shown that erectile dysfunction might be a clinical marker of endothelial dysfunction, and consequently of undetected diabetes, hypertension, dyslipidemia, coronary artery disease and depression. We also address the question of whether urologists should adopt wide-ranging screening regimens for sexual dysfunction.
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PMID:How, why and when should urologists evaluate male sexual function? 1647 Feb 7

Sexual dysfunction is a frequently encountered comorbid condition in patients with many medical and psychiatric conditions, such as epilepsy and depression. Most depressed patients experience some type of sexual dysfunction, decreased sexual desire being the most common. The association of sexual dysfunction with epilepsy is less clear. Changes in sex hormone levels are common in patients with epilepsy and may be attributable to the disease or to antiepileptic drugs (AEDs). Sexual dysfunction associated with depression or epilepsy is generally treated according to standard guidelines for the management of sexual disorders, since data from special populations are not available. The most common forms of female sexual dysfunction are lack of sexual desire and difficulty achieving orgasm. There are no approved pharmacotherapies for female hypoactive sexual desire disorder or female orgasmic disorder. Female sexual arousal disorder is treated with estrogen replacement therapy when indicated or vaginal lubricants. The most common male sexual dysfunction disorders are premature ejaculation and erectile dysfunction. Phosphodiesterase type-5 inhibitor drugs are now the first-line treatment for erectile dysfunction, and selective serotonin reuptake inhibitors and topical anesthetic creams are nonapproved but effective treatments for premature ejaculation. Testosterone and aromatase inhibitors have been used investigationally to treat sexual dysfunction in men taking AEDs. Patient education and follow-up appointments are essential to ensure optimal outcomes of pharmacologic treatments for sexual dysfunction.
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PMID:Pharmacologic treatment strategies for sexual dysfunction in patients with epilepsy and depression. 1687 Nov 36

This is a case report of reboxetine induced erectile dysfunction, seminal emission and ejaculation during defecation and micturition. A 44 year old male who had been suffering from depression without any sexual dysfunction was put on venlafaxine XR treatment. Due to delayed ejaculation and occasional episodes of absence of ejaculation he was switched to reboxetine. At the second week of treatment he reported erectile dysfunction and premature ejaculation, and seminal emission and ejaculation during defecation and micturition occurred later at 8th week of treatment. After he was switched to sertraline 50 mg/day, his erectile dysfunction, premature and spontaneous ejaculation symptoms subsided in 2 weeks. Although reboxetine is reported to be free of sexual side effects, individual vulnerabilities to such unwanted effects should be considered, and sexual dysfunction should be assessed thoroughly during the treatment.
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PMID:Reboxetine induced erectile dysfunction and spontaneous ejaculation during defecation and micturition. 1712 81

Premature ejaculation (PE) is a common sexual dysfunction among the general population. PE has often been associated with a psychological state of mind. Hospital Anxiety and Depression Scale (HADS) can be used as an instrument to assess the emotional and psychological state. The present study was designed to assess the reliability and validity of the HADS in a Malaysian population. The validity and reliability were studied in subjects with and without PE. Test-retest methodology was used to assess the reliability whereas Cronbach's alpha was used to assess the internal consistency. In the control and the PE groups, the internal consistency was good and a high degree of internal consistency was observed for all 14 items. In the control group, the Cronbach's alpha values at baseline were from 0.811 to 0.834, whereas for retest, the Cronbach's alpha values were from 0.821-0.838 items. Intraclass correlation coefficient (ICC) was high for the control (0.797-0.868: baseline and 0.805-0.872: retest) and PE group (0.822-0.906: baseline and 0.785-0.887: retest). The high value of ICC and the internal consistency was due to high reliability and consistency of the items at 2-week interval. A degree of significance between the baseline and week-2 scores was observed across all items in the PE group but not in the control group. The HADS is a suitable, reliable, valid and sensitive instrument to measure the clinical change for anxiety and depression in the Malaysian population.
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PMID:Validation of the hospital anxiety and depression scale and the psychological disorder among premature ejaculation subjects. 1713 3

Ejaculation, although mediated by a spinal ejaculation generator, is subject to descending supraspinal modulation from several brain regions. 5-Hydroxytryptamine (5-HT or serotonin) is involved in ejaculatory control, with its ejaculation-retarding effects likely to be attributable to activation of 5-HT1B and 5-HT2C receptors, both spinally and supraspinally. By contrast, stimulation of 5-HT1A receptors precipitates ejaculation. Selective serotonin reuptake inhibitors (SSRIs), which are used for treatment of psychiatric disorders, can delay ejaculation in humans and are widely used 'off-label' for treatment of premature ejaculation. SSRIs require 1-2 weeks' chronic dosing to be effective, similar to their use for treatment of depression. However, a new short-acting SSRI is effective 'on demand' and might represent the first of a new generation of therapies targeted to premature ejaculation.
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PMID:5-Hydroxytryptamine in premature ejaculation: opportunities for therapeutic intervention. 1716 40

Many men experience sexual function disorders, the most common of which are PE and ED. However, they may hesitate to seek treatment because of the perceived embarrassment associated with discussing their symptoms with a physician. The introduction of PDE-5 inhibitors for the treatment of ED has resulted in increased awareness of men's sexual health; as a result, men may be more willing to discuss their symptoms of sexual dysfunction because they are aware that treatment options are available. An accurate diagnosis is important for effective treatment of sexual dysfunctions and depends on a detailed description of patient symptoms along with a complete sexual history. When forming a diagnosis, physicians must distinguish PE from ED and other sexual dysfunctions. To diagnose PE, a physician should incorporate measures that include personal distress and interpersonal difficulty between the patient and his partner. Premature ejaculation affects many men, and current pharmacologic treatment options are limited to off-label use of medications indicated for the treatment of depression or the distinct sexual dysfunction, ED. Therefore, the development of new pharmacologic treatments for PE is warranted.
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PMID:Distinguishing premature ejaculation from other sexual function disorders. 1846 10

In recent years, more and more attention has been drawn to the role of phosphodiesterase 5 (PDE5) in penile erection. The cyclic nucleotide (cGMP) signaling pathway mediates the smooth-muscle relaxing effect of nitric oxide necessary for normal erectile function. Down-regulation of this pathway is the pathological pivot of many forms of erectile dysfunction (ED) and leads to the development of some chronic diseases. Therapeutic outcomes have shown that vardenafil is effective and safe in the treatment of ED associated with dyslipidemia, hypertension, depression, diabetes, radical retropubic prostatectomy, spinal cord injury, sildenafil failure, renal transplantation, chronic prostatitis and that accompanied by premature ejaculation. Vardenafil provides a reasonable therapeutic alternative for these refractory ED patients. In addition, vardenafil can prolong erectile duration of ED patients.
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PMID:[Vardenafil for refractory erectile dysfunction: the latest advances]. 2021 19

Premature ejaculation (PE) is suspected to be the most prevalent male sexual complaint, and the prevalence of PE is considerably high also in the younger generation. We investigated the PE prevalence based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed text revision; DSM-IV-TR) definition and the risk factors of PE in Korean young men via Internet survey. Subjects (n = 3980) aged from 20 to 59, who performed sexual intercourse more than once a month during the past 6 months were asked to participate in this study. Participants were asked to complete a questionnaire that consisted of questions on general, medical, and sexual history related to ejaculation. A total of 600 subjects were included in this study. PE prevalence was found to be 18.3%. Prevalences were not significantly different across age groups, after excluding subjects with erectile dysfunction (ED). Educational level, marital status and duration, average income, sexual orientation, smoking, alcohol consumption, and circumcision status showed no difference in the PE and non-PE groups. Partners perceived satisfaction rates were 45.0% in the PE group and 63.9% in the non-PE group. Significant differences were found between the PE and non-PE groups in terms of ED, obesity, and depression prevalence. However, multiple logistic regression analysis revealed that the significant risk factors of PE were age and the frequency of conversations with partners about sexual intercourse. This Internet-based study is limited because participants probably represent a selected population of Internet users with non-representative educational and socioeconomic profiles. This study is the first to report the prevalence of both self-reported PE and PE on the basis of the DSM-IV-TR definition in the Korean population. This study demonstrates that PE in Korea is as prevalent as it is in European countries and the United States.
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PMID:Self-reported premature ejaculation prevalence and characteristics in Korean young males: community-based data from an internet survey. 2067 Nov 39


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