Dual approach to ejaculatory control: daily paroxetine and on-demand lidocaine spray for treating premature ejaculation

Background: Premature ejaculation (PE) is a prevalent sexual dysfunction that affects a large number of men and can significantly impact their quality of life and intimate relationships. Current treatment options primarily include behavioral techniques and pharmacological interventions; however, the optimal therapeutic strategies remain unclear. This study aimed to evaluate the efficacy and safety of a combination treatment therapy using daily paroxetine 20 mg and on-demand lidocaine spray in men diagnosed with both erectile dysfunction and premature ejaculation. Methods: A cohort of men aged 18–65, diagnosed with PE and maintaining stable heterosexual relationships for over six months, received the proposed regimen. Results: The findings revealed a significant increase in intravaginal ejaculatory latency time (IELT) along with significant improvements in patient-reported outcomes, highlighting the potential of dual therapy to enhance sexual satisfaction. Conclusions: This single-arm study suggests that the combination of daily paroxetine and on-demand lidocaine spray may improve IELT and patient-reported outcomes in men with PE. However, the lack of a control group limits definitive conclusions. These preliminary findings support the need for future randomized controlled trials to validate the efficacy of this dual therapy compared to monotherapies or a placebo. Clinical Trial Registration: https://www.isrctn.com/ISRCTN31283266?q=ISRCTN31283266&filters=&sort=&off\set=1&totalResults=1&page=1&pageSize=10, ISRCTN31283266.