Quick Takeaways
- Dapoxetine is the only on‑demand SSRI approved for premature ejaculation (PE).
- Other oral SSRIs (paroxetine, sertraline, clomipramine) require daily dosing and have a slower onset.
- Topical anesthetics give fast relief but can cause loss of sensation for both partners.
- Behavioural techniques are drug‑free but need consistency and practice.
- Cost, side‑effect profile, and personal preference decide the best fit.
When you type "dapoxetine comparison" into a search engine you’re looking for a clear answer: how does dapoxetine stack up against the other options on the market? Below you’ll find a ground‑up breakdown of the most common PE treatments, their real‑world performance, and the factors you should weigh before choosing a path.
What is Dapoxetine?
Dapoxetine is a short‑acting selective serotonin reuptake inhibitor (SSRI) that was specifically developed for on‑demand use in premature ejaculation. It increases serotonin levels in the synaptic cleft, which helps delay the ejaculatory reflex. The drug was first approved in Europe in 2009 and is now available in more than 30 countries.
How Dapoxetine Works
Unlike classic SSRIs that stay in the system for days, dapoxetine peaks within 1‑2hours and is cleared in about 12hours. This pharmacokinetic profile lets men take a single tablet 1-3hours before sexual activity, mimicking the convenience of a “pop‑and‑go” solution.
Common Alternatives to Dapoxetine
Below are the six alternatives you’ll most likely encounter when researching PE treatments. Each is introduced with a brief definition and key attributes.
- Paroxetine - a long‑acting SSRI often prescribed off‑label for PE. Typical dose: 20mg daily.
- Sertraline - another daily SSRI used off‑label. Typical dose: 50mg daily.
- Clomipramine - a tricyclic antidepressant with strong serotonergic activity. Typical dose: 25mg daily.
- Lidocaine‑Prilocaine Spray - a topical anesthetic applied directly to the penis 15minutes before intercourse. Provides localized numbness.
- Behavioural Therapy - non‑pharmacological approaches such as the “stop‑start” and “squeeze” techniques. Requires practice and partner involvement.
- Sildenafil - a phosphodiesterase‑5 inhibitor used for erectile dysfunction that can indirectly improve ejaculatory control when combined with other methods.
- Ginkgo Biloba Extract - a herbal supplement claimed to increase penile blood flow and modestly delay ejaculation. Evidence is mixed.
Side‑by‑Side Comparison
| Attribute | Dapoxetine | Paroxetine | Sertraline | Clomipramine | Lidocaine‑Prilocaine Spray | Behavioural Therapy | Sildenafil (adjunct) | Ginkgo Biloba |
|---|---|---|---|---|---|---|---|---|
| Administration | On‑demand oral tablet | Daily oral | Daily oral | Daily oral | Topical spray | Exercise‑based | Daily oral (used with other methods) | Oral supplement |
| Time to effect | 1-3hours | 2-3weeks (steady‑state) | 2-3weeks | 2-3weeks | 15minutes | Several sessions (weeks) | 30minutes-1hour (as adjunct) | Several weeks (variable) |
| Typical dose | 30mg or 60mg | 20mg daily | 50mg daily | 25mg daily | 1-2 sprays per use | Varies (stop‑start, squeeze) | 50mg daily | 120mg daily |
| Side‑effects | Nausea, headache, dizziness | Sexual dysfunction, weight gain | Diarrhea, insomnia | Dry mouth, constipation | Reduced sensation for both partners | Frustration if not practiced well | Headache, flushing | Rare GI upset |
| Contra‑indications | Severe heart disease, MAO‑inhibitors | Current MAOI therapy, bipolar disorder | MAOI use, liver disease | Heart block, glaucoma | Allergy to local anesthetics | None medical, but requires partner cooperation | Concurrent nitrate therapy | Bleeding disorders (high dose) |
| Cost (UK, 2025) | £22‑£35 per pack (30days) | £12‑£18 per month | £13‑£20 per month | £15‑£22 per month | £8‑£12 per bottle (10sprays) | Free (time investment) | £20‑£30 per month | £10‑£15 per month |
Pros and Cons at a Glance
- Dapoxetine
- Pros: On‑demand, fast onset, clinically proven for PE.
- Cons: Short‑term side‑effects, prescription‑only, not suitable for men with certain heart conditions.
- Paroxetine, Sertraline, Clomipramine (Daily SSRIs)
- Pros: Low cost, widely available, some men achieve lasting benefit after weeks.
- Cons: Require daily adherence, slower onset, higher risk of sexual side‑effects.
- Lidocaine‑Prilocaine Spray
- Pros: Immediate effect, no systemic exposure.
- Cons: May numb partner, can feel unnatural, needs precise timing.
- Behavioural Therapy
- Pros: No medication, improves overall sexual communication.
- Cons: Demands practice, success varies by commitment.
- Sildenafil (as adjunct)
- Ginkgo Biloba
How to Choose the Right Option for You
Think of the decision as a simple checklist. Answer each question honestly, then match your profile to the most suitable row in the table above.
- Do you need a fast‑acting solution for occasional use? → Dapoxetine or topical spray.
- Are you comfortable taking a daily pill and waiting a few weeks for benefit? → Paroxetine, Sertraline, or Clomipramine.
- Do you want to avoid any medication? → Behavioural techniques or a herbal supplement (with realistic expectations).
- Do you have cardiovascular disease or are you on nitrates? → Avoid dapoxetine and sildenafil, consider behavioural or non‑systemic options.
- Is cost a major factor? → Daily SSRIs are cheapest per month, but consider the total cost of multiple prescriptions.
Practical Steps to Start Treatment
- Consult a qualified GP or urologist. Mention any current meds, especially antidepressants or heart drugs.
- Ask specifically for dapoxetine if you want the on‑demand route. The doctor will usually start with 30mg and adjust to 60mg if tolerated.
- If you prefer a daily SSRI, discuss the risk‑benefit profile; the doctor may start at a low dose to minimise side‑effects.
- For topical spray, purchase a reputable brand, test a small area for skin reaction, and apply 15minutes before intercourse.
- Start a behavioural program with your partner - use a timer or apps that guide the “stop‑start” cadence.
- Track your progress. Keep a simple log: date, treatment used, ejaculatory latency time, side‑effects, and overall satisfaction.
When to Seek Further Help
If you’ve tried two different approaches for at least six weeks without noticeable improvement, it’s time to revisit the clinician. Persistent anxiety, relationship strain, or any severe side‑effects (e.g., chest pain with dapoxetine) warrant immediate medical attention.
Frequently Asked Questions
Is dapoxetine safe for men over 50?
Safety data show dapoxetine can be used up to age 65 provided the man has no serious heart disease, uncontrolled hypertension, or is not on interacting drugs like MAO‑inhibitors. A doctor will usually order a baseline ECG for older patients.
Can I combine dapoxetine with a topical spray?
Combining them is generally safe because dapoxetine works systemically while the spray acts locally. However, the combined numbness may feel excessive for some couples, so start with a low‑dose spray and assess comfort.
How long does the benefit of daily SSRIs last after stopping?
Because SSRIs remain in the system for several days, some men notice a lingering improvement for 1‑2weeks after discontinuation. Full effect disappears as serotonin levels return to baseline.
Are there any natural foods that boost serotonin for PE?
Foods rich in tryptophan-like turkey, nuts, seeds, and bananas-support serotonin synthesis, but the effect is modest. They’re best used as part of a balanced diet rather than a primary treatment.
What should I do if I experience dizziness after taking dapoxetine?
Sit or lie down, hydrate, and avoid driving. If dizziness persists beyond 30minutes or is accompanied by palpitations, seek medical advice promptly.
5 Comments
When faced with a choice between a swift, on-demand pill and a slow‑burn daily regimen, one might wonder what the true cost of patience is. The rhythm of intimacy, after all, does not wait for a pharmacological calendar. Dapoxetine offers that fleeting moment of control without the baggage of a month‑long commitment. Yet the shadow of side‑effects looms, reminding us that convenience bears its own price. Ultimately, the decision rests on a personal calculus of risk versus reward.
Yo, you ever think the pharma dudes are just testing us with all these "options"? They push dapoxetine like it’s the holy grail, but forget to mention the hidden agenda – keep us buying pills forever. I mean, why not just stick to a daily SSRI and let the companies rake in cash on a subscription model? And those sprays? Probably just a way to sell more gear. Stay woke, folks.
I appreciate the clear breakdown of each treatment. The table makes it easy to compare costs and side‑effects. It’s helpful for anyone trying to decide what fits their lifestyle best.
First, let’s address the naive optimism that a single tablet can solve a complex sexual dysfunction without any lifestyle changes. Dapoxetine may delay ejaculation, but it does nothing for the underlying anxiety that often fuels premature ejaculation; you’re merely masking symptoms. Second, the side‑effect profile, though marketed as mild, includes nausea, dizziness, and even rare cardiac events, which many users overlook in their enthusiasm. Third, daily SSRIs, while slower, can lead to more sustainable neurochemical adjustments, offering a longer‑term benefit that on‑demand pills lack. Fourth, topical anesthetics, though effective instantly, can diminish pleasure for both partners, undermining relationship intimacy-a factor often omitted from promotional materials. Fifth, behavioural therapy, while requiring effort, teaches you to control the reflex at its source, a skill no medication can replace. Sixth, cost considerations go beyond the monthly price tag; you must factor in doctor visits, labs, and potential follow‑up appointments. Seventh, the table cites UK prices, but international pricing varies dramatically, and insurance coverage can make a huge difference. Eighth, if you have cardiovascular disease, dapoxetine is contraindicated, narrowing your options further. Ninth, many men report that the psychological dependence on a “pop‑and‑go” pill erodes confidence in their natural ability. Tenth, combining dapoxetine with a spray may exacerbate numbness, leading to a loss of sensation that can be distressing. Eleventh, the “quick takeaways” oversimplify the reality that each method requires a personalized approach. Twelfth, you should also consider the partner’s experience; a treatment that harms their pleasure is counterproductive. Thirteenth, the evidence base for herbal supplements like ginkgo is weak, offering false hope. Fourteenth, you need a structured log to truly assess efficacy, something the article only mentions in passing. Fifteenth, after discontinuing daily SSRIs, some men retain a modest benefit, suggesting neuroplastic changes that dapoxetine cannot achieve. Finally, always discuss these options with a qualified urologist who can tailor a plan to your specific health profile.
Great summary thanks