There are two medical treatments which are at present most often used to help men with *Premature Ejaculation*. These are Clomipramine and Paroxetine. There are several others, but these are the commonest.

Clomipramine may be taken in two ways.

1. As a 25-50 mg tablet one hour before intercourse.
2. Every day in a small dose of 10 mg, which is increased by 10 mg each week until improvement shows, but not more than 60 mg. After three to six weeks at that level, it is then reduced each week by 10 mg.

This drug is one of a group, the tricyclics, which are used as antidepressants, but in a dose below what you would have for depression. Because the dose is small, the usual side effects are less common, and wear off easily. This drug can work for up to 75% of cases. The premature ejaculation can return after treatment is stopped, and at times of stress and pressure, unless the underlying cause of the problem is resolved.

Paroxetine is another antidepressant. When it is taken in a dose of 40 mg/day, it can help a man get much better control of ejaculation. Rarely this drug (and others in the same group such as sertraline, and fluoxetine) can cause reduced sex drive or desire, or erection difficulties, when taken on a regular basis.

These medications have to be prescribed by a doctor.