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Not yet recruitingNCT07057011Updated Jul 9, 2025

Therapeutic Outcomes of Selective Serotonin Reuptake Inhibitors and Phosphodiesterase-5 Inhibitors Combination Therapy Versus Monotherapy

An interventional study of Paroxetine 20 Mg Oral Tablet in Premature Ejaculation, sponsored by South Valley University. Not yet recruiting at 1 site in Egypt. Open to male participants aged 18 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-07-09.

Sponsored by South Valley University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
Male
01

Study summary

Premature ejaculation (PE) is a prevalent male sexual dysfunction that affects as many as 20-30% of men regardless of age and ethnicity.The International Society for Sexual Medicine defines premature ejaculation as a male sexual dysfunction characterised by ejaculation that always or nearly always occurs before or within about 1 minute of vaginal penetration from the first sexual experience (lifelong premature ejaculation) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired premature ejaculation), the inability to delay ejaculation on all or nearly all vaginal penetrations and with negative personal consequences include distress, bother, frustration, and avoidance of sexual intimacy.

Read the detailed description

Oral intake of tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI) has emerged as effective for patients with PE whether or not these patients suffered from depression. Sildenafil, a phosphodiesterase-5 inhibitor (PDE5i), was tried for premature ejaculation, and in one study associated with paroxetine (a SSRI), with IELT (intravaginal ejaculation latency time) going from 0.35 to 4.5 min.

Serotonin (5-hydroxytryptamine, 5-HT) plays an important role at the level of the central nervous system in the complex regulatory mechanisms involved in ejaculation. In clinical practice, selective serotonin reuptake inhibitor (SSRI) antidepressants (e.g., paroxetine, fluoxetine and sertraline) and the tricyclic antidepressant clomipramine are widely used to treat lifelong PE, suggesting that 5-HT and SSRIs play roles in the pathophysiology and treatment of PE. In this group, paroxetine and sertraline are often used effectively to treat PE, although none of these agents have been officially recognized as treatments for this condition.

SSRIs increase synaptic 5-HT concentrations in the ejaculation-related areas of the central nervous system by blocking 5-HT transporters. The serotonin transporter (5-HTT) plays an important role in the clearance of synaptic 5-HT, thereby regulating presynaptic and postsynaptic 5-HT receptor stimulation. Human 5-HTT is encoded by a single gene (SLC6A4) on chromosome 17q12. A polymorphism in the transcribed region can be caused by a 44-bp insertion ('long allele' [L]) or deletion ('short allele' [S]).

The transcriptional activity of the L allele has been reported to be twice as high as the S allele. Theoretically, men with one or more S alleles for the 5-HTT have fewer functioning transporters and could therefore lead to a higher serotonergic neurotransmission. Consequently, it is postulated that men with SS genotype have longer IELT durations than men with LL genotype.In the literature, a variety of findings have been reported concerning the relationship between 5-HTT polymorphism and the SSRI response.

02

Conditions studied

  • Premature Ejaculation

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03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Inclusion criteria

  • Patients with PE: Men aged 18-60 years with a diagnosis of PE according to the International Society for Sexual Medicine (ISSM) criteria.
  • Healthy controls: Men aged 18-60 years without a history of PE or other sexual dysfunctions.

Exclusion criteria

Exclusion Criteria:

  • Other sexual dysfunctions: Erectile dysfunction, delayed ejaculation, or other sexual disorders.
  • Cardiovascular disease: history of cardiovascular disease, hypertension, or stroke.
  • Neurological or psychiatric disorders: Conditions that may affect sexual function, such as depression, anxiety, or Parkinson's disease.
  • Medications affecting sexual function: Current use of medications that may impact sexual function, such as antidepressants or antipsychotics.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Active comparator
    Group A (Drug Comination Therapy)

    Twenty patients with premature ejaculation , matching inclusion \& exclusion criteria as mentioned before, will receive SSRI (paroxetine 20mg/day) + PDE5 inhibitor (sildenafil 25mg/day) for 3 months . Follow up clinically every 4 weeks for 12 weeks.

    Drug: Paroxetine 20 Mg Oral Tablet

  • Active comparator
    Group B (Monotherapy)

    Twenty patients with premature ejaculation will receive SSRI (paroxetine 20mg/day) + placebo for 3 months . Follow up clinically every 4 weeks for 12 weeks.

    Drug: Paroxetine 20 Mg Oral Tablet

  • Active comparator
    Group C (Control)

    Twenty healthy matched individuals will receive placebo + placebo for 3 months . Follow up clinically every 4 weeks for 12 weeks.

    Drug: Paroxetine 20 Mg Oral Tablet

Interventions

  • DrugParoxetine 20 Mg Oral Tablet

    to compare the safety and efficacy of paroxetine alone versus the combination of paroxetine and sildenafil in Premature Ejaculation Patients with genetic polymorphism in the serotonin transporter gene-linked polymorphic region.

    Also known as: sildenafil 25mg Oral Tablet, Placebo

05

What researchers measure

Primary outcomes

  1. Treatment of premature ejaculation

    Treating the patients whom having Premature Ejaculation with selective serotonin reuptake inhibitors and Phosphodiesterase-5 Inhibitors Combination Therapy with genetic polymorphism in the serotonin transporter gene-linked polymorphic region.

    Time frame: 3 months

06

Study locations

1 site
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07057011
Lead sponsor
South Valley University
Responsible party
Mohamed Ahmed Mohamed (Resident at Dermatology , venereology and andrology, Faculty of medicine, South Valley University) — Principal investigator
First posted
Jul 9, 2025
Start date
Jul 1, 2025 (estimated)
Primary completion
Feb 1, 2026 (estimated)
Completion
Feb 10, 2026 (estimated)
Last update
Jul 9, 2025

Study contacts

Mohamed Ahmed Mohamed Mousaa, MSC
Contact
drmohamedelmurshedy@gmail.com
+201061574354
Mohammed Hosny Hassan., professor
Contact
mohammedhosnyhassaan@med.svu.edu.eg
+201098473605
Mostafa Adam Ali El-Taib, Professor
study chair · Dermatology, venereology and andrology ,Qena Faculty of medicine ,south valley university.
Ebtehal Alaa El-Din Kotop Mohamed, Lecturer
study director · Dermatology, venereology and andrology ,Qena Faculty of medicine ,south valley university.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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