Reference	Number and entry criteria	Intervention	Duration	Age	Outcomes	Results	Adverse effects	Quality
Taken before sexual activity
Segraves et al, 1993 USA	29 men <1 minute or before 8 penile-vaginal strokes	Clomipramine 25 mg 6 hours before coitus parallel group	10 coital experiences	47 ± 10.2 placebo 45 ± 7.5 clomipramine	Men achieving at least 2 minutes intravaginal latency	Intravaginal latency 6.1 minutes clomipramine 0.9 minutes placebo	2/10 erectile difficulties with clomipramine	r = 1 db = 2 w = 0
Haensel et al, 1996 USA and Holland	8 men premature ejaculation 6 men with erectile dysfunction and premature ejaculation 8 controls	Placebo or 25 mg clomipramine 12 to 24 hours before sexual activity cross-over	Two 3-week periods	42 (range 31 to 62) 41 (26 to 52) 41 (26 to 52)	Intravaginal latency plus others	Intravaginal latency increased from 2 minutes on placebo to 8 minutes with clomipramine in men with premature ejaculation, no change in men with additional erectile dysfunction (about 2 minutes) and increased latency in normal controls from 9 to 11 minute	No ejaculation failures noted	r = 1 db = 2 w = 1
Biri et al, 1998 Turkey	37 men latency <1 minute	Sertraline 50 mg or placebo in the evening parallel group	4 weeks	31 (range 21 to 54)	Intravaginal latency	Median intravaginal latency 0.7 minutes baseline 1.9 minutes placebo 5.4 minutes sertraline	No ejaculation failures noted	r = 1 db = 2 w = 1
Strassberg et al, 1999 USA and Holland	23 premature ejaculation <2 minutes 11 control subjects	Clomipramine 50 mg or placebo 4-6 hours before sexual activity cross-over	Two 2-week periods	46 (range 21 to 73)	Intravaginal latency	Mean intravaginal latency 0.9 minutes on placebo 3.8 minutes on clomipramine Control latency was 8 minutes increased to 11 minutes on clomipramine in 4 subjects	No ejaculation failures noted	r = 1 db = 2 w = 1
McMahon & Touma, 1999 study 1	26 men with intravaginal latency <1 minute	Paroxetine 20 mg or placebo 4-6 hours before sexual activity cross-over	Two 4-week periods with 3 week washout	40 (range 19 to 55)	Intravaginal latency and coitus frequency	Median intravaginal latency 0.3 minutes baseline 0.5 minutes placebo 3.2 minutes paroxetine	No ejaculation failures noted	r = 1 db = 0 w = 0
McMahon & Touma, 1999 study 2 Australia	42 men with intravaginal latency <1 minute	Paroxetine 10 mg daily for 2 weeks then 20 mg as needed 4-6 hours before sexual activity for 4 weeks or placebo in a similar schedule cross-over	Two 7-week periods with 3 week washout	41 (range 20 to 51)	Intravaginal latency and coitus frequency	Median intravaginal latency 0.5 minutes baseline 0.8 minutes placebo 6.0 minutes paroxetine	3 ejaculation failures with paroxetine	r = 1 db = 0 w = 0
Daily dosing
Waldinger et al, 1994 Holland	17 men with intravaginal latency <2 minutes in more than 50% coital attempts	Paroxetine or placebo 20 mg daily for 1 week, then 40 mg daily for 5 weeks parallel group	6 weeks	40 (range 24 to 48)	Latency time	Paroxetine (n=6) latency 10 minutes (5-20) 6/6 >5 min Placebo (n=8) latency 0.25 minutes (0-2) 0/8 >2 min	No significant differences	r = 1 db = 2 w = 1
Mendels et al, 1995 USA	52 men with intravaginal latency <1 minute in more than 50% coital attempts	Sertraline or placebo 50-200 mg daily titrated over 3 weeks parallel group	10 weeks	Range 25 to 52 years	Intravaginal latency plus others	Mean intravaginal latency at endpoint 5.4 minutes sertraline 1.8 minutes placebo	Ejaculation failure 5/26 sertraline 0/26 placebo	r = 2 db = 2 w = 1
Althof et al, 1995 USA	15 men with self-reported mean time to ejaculation <4 minutes	Placebo, 25 mg or 50 mg clomipramine daily cross-over	Sufficient for at least 5 occasions of intercourse	38 (range 23 to 56)	Intravaginal latency plus others	Mean intravaginal latency 1.3 minutes at baseline 3.4 clomipramine 25 mg 7.0 clomipramine 50 mg	No ejaculation failures noted	r = 1 db = 1 w = 1
Kara et al, 1996 Turkey	17 men with intravaginal latency <2 minutes in more than 50% coital attempts	Placebo or fluoxetine 20 mg daily for 1 week, then 40 mg daily parallel group	4 weeks	32 (range 15 to 50 years) all married	Intravaginal latency	Mean pre-treatment intravaginal latency was 0.5 minutes. After 4 weeks treatment it was 3 minutes with fluoxetine and 1 minute in the placebo group.	None mentioned	r = 1 db = 1 w = 0
Waldinger et al, 1997 Holland	34 men with primary premature ejaculation with intravaginal latency <1 minute	Paroxetine 20 mg or 40 mg daily parallel group	8 weeks	44 (range 23 to 57)	Intravaginal latency	Median intravaginal latency 0.2 minutes (0-0.5) baseline 5.0 minutes (0.2 to 30) 8 weeks on 20 mg 9.0 minutes (1 to 20) 8 weeks on 40 mg	Ejaculatory failure 2/17 20 mg 4/17 40 mg	r = 1 db = 2 w = 1
McMahon, 1998 Australia	37 men with latency <1 minute	Sertraline or placebo 50 mg daily cross-over	Two 4-week periods with 4 week washout	41 (range 19 to 70)	Intravaginal latency and coitus frequency	Median intravaginal latency 0.6 minutes baseline 1.0 minutes placebo 3.2 minutes sertraline	2/37 ejaculatory failures	r = 1 db = 2 w = 1
Kim & Seo, 1998 Korea	36 men with latency <2 minutes	Fluoxetine 40 mg Sertraline 100 mg Clomipramine 50 mg placebo cross-over	Four 4-week periods with 1 week washout between	44 (range 30 to 60)	Intravaginal latency	Median intravaginal latency after 4 weeks 0.8 minutes baseline 2.3 minutes placebo 2.3 minutes fluoxetine 4.3 minutes sertraline 5.8 minutes clomipramine	No ejaculation failures noted	r = 0 db = 2 w = 1 note: does not state randomised, but implied in text