Does lidocaine ointment addition increase fluoxetine efficacy in the same group of patients with premature ejaculation?

PURPOSE: To evaluate the efficacy of fluoxetine alone and fluoxetine+lidocaine ointment in the same patient group with premature ejaculation (PE).

MATERIAL AND METHODS: 78 patients with PE were given 20 mg fluoxetine by an 'as-needed treatment' 4 h before planned sexual activity for a period of 3 months. They were then told to add local lidocaine ointment to fluoxetine 30 min before sexual activity for an additional 3 months for most of their sexual attempts. They were asked to note their PE grades and intravaginal ejaculatory latency time (IELT) scores by stopwatch technique before and after each treatment modality; the results were compared statistically afterwards.

RESULTS: Of 46 patients who completed the study, the mean pretreatment, fluoxetine alone and fluoxetine+lidocaine ointment treatment PE grades and IELT scores were found to be 6.52+/-1.42 and 2.58+/-0.49, 3.21+/-1.86 and 1.28+/-0.71, 2.17+/-1.56 and 1.04+/-0.72, respectively, showing a decrease in PE grades and IELT scores in combined therapy. On an individual patient basis, the total significant and moderate improvement rate of combined therapy was found to be 86.9%. Failure was observed in 6 (13.1%) patients.

CONCLUSION: The effective treatment with fluoxetine+lidocaine ointment offers the advantage of an 'as-needed treatment' in PE with minimal side effects and can be used as one of the first-line alternatives in the treatment of PE.