Doxazosin, a Selective Alpha-1 Blocker, in the Treatment of Premature Ejaculation

Objective: Pharmacotherapy for premature ejaculation has been widely used for years. The efficacy of antidepressants, especially SSRIs, has been confirmed by many randomized controlled studies. The orthosympathetic activity on the ejaculatory system is a well-studied entity. In this study, our purpose is to evaluate the efficacy of a selective α-1 blocker, doxazosin, in the treatment of premature ejaculation. Material and Methods: The study comprised 42 patients (mean age 39.11) out of a total of 44 patients with PE who were referred to Ege University Urology Outpatient Clinic from September 2000 to June 01. Among them, 27 patients were asked to use a daily dose of 4 mg of the α-blocker doxazosin for 6 weeks. The control group consisted of 15 patients who were asked to use 4 mg of placebo (starch) in the same way as doxazosin. After a therapy of 6 weeks, all the patients were interviewed to assess the efficacy of the therapy and to report any side effects. Results: There was a significant increase in the latency of ejaculation with doxazosin in 12 out of a total of 27 patients (44.40%) compared to placebo, where only 2 out of 13 patients (13.30%) showed a similar effect. The effect of doxazosin was found to be statistically significant (p<0.043). The side effect profile showed no significant difference between doxazosin and placebo. Conclusion: The result of our study indicates that doxazosin is safe and effective in patients with PE. Its activity is comparable to phenoxybenzamine and clomipramine, as reported in the literature. Additionally, its significantly lower and milder adverse effect profile appears to be an advantage.