Dapoxetine vs Paroxetine for Premature Ejaculation: Pros and Cons

Among the remedies for premature ejaculation (PE), antidepressants are known mostly as off-label medicines. Their effect is based on the ability to delay orgasm, which is used in comprehensive treatment together with behavioral techniques and exercises. The only selective serotonin reuptake inhibitor (SSRI) intended purposely for the condition when a man ejaculates sooner than expected is dapoxetine marketed under the trade name Priligy. Another popular SSRI prescribed for this delicate man’s health disorder is paroxetine (trade name Paxil) that is used for depression and anxiety disorders, but also found useful for premature ejaculation. Here we compare these two probably most often recommended options for medical PE treatment.

Paxil (Paroxetine) Effect and Administration

Paroxetine is psychotropic drug used for anxiety and depressions, as well as for treatment of symptoms of premenstrual dysphoric disorder. Paxil was the first SSRI studied in relation of treatment of premature ejaculation as early as in 1994 and it demonstrated significant improvement in IELT (Inter-Vaginal Latency Time). It was the beginning of new era in PE treatment. Although usage of antidepressants for PE is still contradictory in many cases, many men enhance their ability to maintain an erection longer, without ejaculating shortly after vaginal penetration. Despite of this, Paxil remains off-label medicine for regulating the problems with ejaculation.

Similar to dapoxetine and other SSRIs, paroxetine works adjusting serotonin levels in the brain. Paxil is a strong antidepressant and you should take it strictly as prescribed by your doctor. It helps regulate your mood and eliminate anxiety symptoms. In fact, its ability to delay orgasm was initially known as adverse affect of the medicine, but later it was studied in a few trials and Paxil was found powerful for PE. For this condition, paroxetine should be taken daily; its on-demand efficacy is questionable, although there are some reports from scientists of University of Chile that they found paroxetine equally effective when taken on demand and on permanent base. Actually, you may expect stable improvement in 2 weeks after the beginning of treatment, but in some cases it may require 2-4 weeks. You should choose the proper dosage with your doctor, as the action of paroxetine may differ in every patient.

Studies of Australian Centre for Sexual Health conducted in 1996 and 1997 demonstrated high effectiveness of paroxetine, if applied on the regular base. The subjects of study were 94 men in age 18-61. After 4 weeks of treatment mean IELT increased from 0.4 to 4.5 min. Among the adverse effects recorded were unejaculation (in 5 of 61 men), inhibited orgasm and lowering libido. Paxil can interact with other drugs. You cannot use paroxetine with MAO inhibitors and some other drugs. For more information, please read prescription information attentively and consult your doctor.

Priligy and Paxil Comparison

Both Priligy and Paxil belong to the same group of selective serotonin reuptake inhibitors – that are the class of antidepressants – and were found effective for treatment of premature ejaculation, but each of these medicines has its pros and cons. No extended comparative research was undertaken but we, nonetheless, have some data on the both of them. Here please find a brief summary of the main characteristics of the medications.

Characteristic Paxil (paroxetine) Priligy (dapoxetine)
Medicine specially developed for PE
(off-label use)
Efficacy +++, ++ +++, ++
On-demand use + ++, +
Side effects +++, ++ ++, +
Attractive price ++ +
FDA approval*

+++ Present at high degree

++ Medium degree

+ Low degree

– Not present

* For the U.S.

As you can see, at approximately the same efficacy Paxil offers better prices, but has more adverse affects. It is not the medicine primarily intended for treatment of PE. At the same time, brand Priligy is rather overpriced as it is promoted as the only medicine specially developed for premature ejaculation. Dapoxetine features milder side effects and it is more suitable for on-demand use, though, the former is the subject to check up on practice together with your doctor.

Please note that Priligy is not marketed in the U.S., as it is still under studying, but it is widely distributed in Europe, Middle East, Asia, Latin America and Africa. Currently, pharmaceutical company Menarini has all the commercial right for this product granted on the base of agreement with the right holder Furiex Pharmaceuticals. If you are seeking for generic dapoxetine for cost saving, it is on your own risk, as the patent rights on this medicine are not expired yet. Beware online scamming and non-reputable online shops. As for Paxil, it is widely available in the US and you can check for better price options.

Dapoxetine vs Paroxetine: Conclusion

You are free to choose an option you feel suits you better, but keep in mind that it is often not your choice which medicine to use. Medicine can act differently for different people and sometimes you need a number of tries to find what is better for you. If it happens that both Paxil and Priligy are failed, you may try some other medicine of SSRI or PDE5 range. Please always talk to your doctor if the results are not satisfactory and you are looking for improvement, do not decide on your own.