Dapoxetine vs Paroxetine in Treatment of Premature Ejaculation: Pros and Cons

Among the remedies for premature ejaculation (PE), antidepressants are known mostly as off-label medicines. Their effect is based on the ability to delay orgasm, which is used in comprehensive treatment together with behavioral techniques and exercises. The only selective serotonin reuptake inhibitor (SSRI) intended purposely for the condition when a man ejaculates sooner than expected is dapoxetine marketed under the trade name Priligy. Another popular SSRI prescribed for this delicate man’s health disorder is paroxetine (trade name Paxil) that is used for depression and anxiety disorders, but also found useful for premature ejaculation. Here we compare these two probably most often recommended options for medical PE treatment.

Priligy (Dapoxetine) Effect and Administration

Originally developed by Eli Lilly company, dapoxetine was reassigned for treatment of premature ejaculation due to its quick absorption and excretion from the body, which make the medication not very suitable as an antidepressant, but good for PE issues, as it has less unwanted side effects associated with SSRIs.

For treatment of one the most annoying man’s sexual disorders, you have to take Priligy regularly at least for 2-3 weeks. It is not kind of medicine that can be taken when needed, as PDE5 inhibitors for erectile dysfunction, though some sources promote it as on-demand medicine. It demonstrates some feasible results when taken occasionally, but you need some time to feel a better effect of the drug on your sexual function. Make sure you take dapoxetine less than 3 hours before prospective sexual intercourse as it absorbs quite fast.

It is believed that dapoxetine action is based on inhibiting serotonin transporter and increasing its action, but this mechanism is not studied well. At the same time, clinical trials have proved the effectiveness of the drug. A double-blind placebo controlled Dapoxetine phase III trial that was undertaken by Australian Centre for Sexual Health in 2012 demonstrated significant improvement in time of ejaculation after the sexual penetration. The study included 6,081 men with approx. one-third of them receiving 30 mg and 60 mg doses of dapoxetine. The men who took 30 mg doses improved their IELT (Inter-Vaginal Latency Time) indicators in average from 0.9 min in a base line to 3.1 min, and those who were given 60 mg reached 3.6 min. At the same time, the participants who received placebo were not able to surpass 1.9 min limit.

As any SSRI, dapoxetine has such common side effects as nausea, dizziness, diarrhea, somnolence and some other, but they are milder than with other antidepressants. If you are planning to take Priligy, you should take into consideration its possible interaction with other drugs as PDE5 inhibitors and medicines for hypertension. Other Important Notes on Priligy at Smart Canadian Pharmacy website: https://www.smartcanadianpharmacy.com/priligy-dapoxetine.html

Premature-Ejaculation-dapoxetine

Paxil (Paroxetine) Effect and Administration

Paroxetine is psychotropic drug used for anxiety and depressions, as well as for treatment of symptoms of premenstrual dysphoric disorder. Paxil was the first SSRI studied in relation of treatment of premature ejaculation as early as in 1994 and it demonstrated significant improvement in IELT (Inter-Vaginal Latency Time, learn more on wiki: https://en.wikipedia.org/wiki/Intravaginal_ejaculation_latency_time). It was the beginning of new era in PE treatment. Although usage of antidepressants for PE is still contradictory in many cases, many men enhance their ability to maintain an erection longer, without ejaculating shortly after vaginal penetration. Despite of this, Paxil remains off-label medicine for regulating the problems with ejaculation.

Similar to dapoxetine and other SSRIs, paroxetine works adjusting serotonin levels in the brain. Paxil is a strong antidepressant and you should take it strictly as prescribed by your doctor. It helps regulate your mood and eliminate anxiety symptoms. In fact, its ability to delay orgasm was initially known as adverse affect of the medicine, but later it was studied in a few trials and Paxil was found powerful for PE. For this condition, paroxetine should be taken daily; its on-demand efficacy is questionable, although there are some reports from scientists of University of Chile that they found paroxetine equally effective when taken on demand and on permanent base. Actually, you may expect stable improvement in 2 weeks after the beginning of treatment, but in some cases it may require 2-4 weeks. You should choose the proper dosage with your doctor, as the action of paroxetine may differ in every patient.

Studies of Australian Centre for Sexual Health (official website) conducted in 1996 and 1997 demonstrated high effectiveness of paroxetine, if applied on the regular base. The subjects of study were 94 men in age 18-61. After 4 weeks of treatment mean IELT increased from 0.4 to 4.5 min. Among the adverse effects recorded were unejaculation (in 5 of 61 men), inhibited orgasm and lowering libido.

Paxil can interact with other drugs. You cannot use paroxetine with MAO inhibitors and some other drugs. For more information, please read prescription information attentively and consult your doctor.

Priligy and Paxil Comparison

Both Priligy and Paxil belong to the same group of selective serotonin reuptake inhibitors – that are the class of antidepressants – and were found effective for treatment of premature ejaculation, but each of these medicines has its pros and cons. No extended comparative research was undertaken but we, nonetheless, have some data on the both of them. Here please find a brief summary of the main characteristics of the medications.

Characteristic Paxil (paroxetine) Priligy (dapoxetine)
Medicine specially developed for PE
(off-label use)
+++
Efficacy +++, ++ +++, ++
On-demand use + ++, +
Side effects +++, ++ ++, +
Attractive price ++ +
FDA approval*

+++ Present at high degree

++ Medium degree

+ Low degree

– Not present
* For the U.S.

As you can see, at approximately the same efficacy Paxil offers better prices, but has more adverse affects. It is not the medicine primarily intended for treatment of PE. At the same time, brand Priligy is rather overpriced as it is promoted as the only medicine specially developed for premature ejaculation. Dapoxetine features milder side effects and it is more suitable for on-demand use, though, the former is the subject to check up on practice together with your doctor.

Please note that Priligy is not marketed in the U.S., as it is still under studying, but it is widely distributed in Europe, Middle East, Asia, Latin America and Africa. Currently, pharmaceutical company Menarini has all the commercial right for this product granted on the base of agreement with the right holder Furiex Pharmaceuticals.

If you are seeking for generic dapoxetine for cost saving, it is on your own risk, as the patent rights on this medicine are not expired yet. Beware online scamming and non-reputable online shops. As for Paxil, it is widely available in the US and you can check for better price options. See inftormation about Paxil on Drugs.com: https://www.drugs.com/paxil.html.

Conclusion

You are free to choose an option you feel suits you better, but keep in mind that it is often not your choice which medicine to use. Medicine can act differently for different people and sometimes you need a number of tries to find what is better for you. If it happens that both Paxil and Priligy are failed, you may try some other medicine of SSRI or PDE5 range. Please always talk to your doctor if the results are not satisfactory and you are looking for improvement, do not decide on your own.

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I Know that Canadian Viagra Treats! Why Should Else I Prescribe It?

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Viagra vs. Cialis: Canadian Pharmacy Research

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What Is Viagra and How Does It Work?

In fact, Viagra is a well-known erectile dysfunction treatment that is widely spread and used. People who have such issues know almost everything about Viagra, its side effects, cautions and other details. However, having ED problem for the first time you should know that it does not work at once. At least half an hour should pass to notice the first results. You will be able to enjoy the effect for approximately 4 hours. In general, it is an advantageous treatment, though there is one great drawback – price.

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What Is Different about Cialis?

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Differences and Similarities of Viagra and Cialis

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2. Both medications have similar side effects. However, the ones caused by Cialis are more protracted as they follow the effect.

3. Viagra is recommended to take on the empty stomach, while Cialis is not affected by food, so it can be taken anytime.

4. Various types of both medicines are offered at Canadian Pharmacy to satisfy even the most exacting customer and please him with a range of available drugs.

More information and references:

About Canadian viagra and viagra types: http://www.canadianhealthcaremalll.com/canadian-viagra-and-viagra-types

About Canadian cialis and cialis types: http://www.canadianhealthcaremalll.com/canadian-cialis-and-cialis-types

Buy discounted Prescription Medications from Canadian online Pharmacy

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Rule of Canadian online pharmacy:

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Life with diabetes – Driving: Health and Care

DRIVING

If I have diabetes, do I have to declare this when applying for a driving licence? If so, will I have to prove I am fit to drive?

Anyone whose diabetes is treated by diet alone does not need to inform the DVLA (Driving and Vehicle Licensing Agency). If your diabetes is treated by tablets or insulin, you must declare this when applying for a driving licence. If you already hold a driving licence, you must tell the DVLA as soon as you have been diagnosed. Life with diabetes

When you have notified the DVLA, you will receive a form asking for details about your diabetes and the names of any doctors whom you see regularly health care mall. You will be asked to sign a declaration allowing your doctors to disclose medical details about your condition. There is usually no difficulty over someone with diabetes obtaining a licence to drive, though the bureaucracy may be irritating. The DVLA now advises people to test their blood glucose before driving, which is another cause of frustration but at least ensures that it is safe for you to drive.

If you are treated by tablets, you will be able to obtain an unrestricted licence, provided that you undertake to inform the DVLA of any change in your treatment or if you develop any complications of diabetes.

If you are treated by insulin, the licence will be valid for only three years instead of up to the age of 70, which is normal in the UK. It is the risk of sudden and severe hypoglycaemia which makes people liable to this form of discrimination. In general the only people who have difficulty in obtaining a licence are those on insulin with very erratic control and a history of hypos causing unconsciousness. Once their condition has been controlled and severe hypos abolished, they can reapply for a licence with confidence.

Diabetes UK has successfully campaigned for regulations on Cl licences to be changed. Previously, blanket restrictions were imposed on insulin users wishing to drive small vans and lorries between 3.5 and 7.5 tonnes. The revised regulations enable anyone taking insulin to be individually assessed on their fitness to drive, even if they have previously had their entitlement withdrawn. Restrictions on other Group 2 vehicles (heavier vehicles and passenger-carrying vehicles, such as minibuses) remain. For more information, contact Diabetes UK.

When I was filling out a form for the DVLA, one of the questions asked whether I had had laser treatment in both eyes. Why do the DVLA need this information?

The DVLA may ask you to have a ‘visual fields test’ if you have had laser treatment in both eyes Canadian health and care mall official website http://www.canadianhealthcaremalll.com , and your licence will be revoked if you cannot pass this test. The reason behind this is that in a few cases, very heavy laser therapy can reduce the field of vision – making it like looking through a keyhole. If you are having a visual fields test, you should have the type in which both eyes are tested at the same time. This test is the DVLA driving standard.

Radiotherapy course

All patients were operated in the same institution by two experienced surgeons working in close collaboration with one of the radiotherapists. The SST was resected by means of a high extended posterolateral approach. In three patients with an anterior-mediastinal localization, a hemi-clamshell incision was carried out. The goal was a radical resection (R0) of at least the upper lobe en bloc with the chest wall. Only in the anterior chest wall resection, an artificial layer was used for reconstruction. For the posterior localization, the scapula was considered to be sufficient as a firm chest wall coverage. Postoperative mortality was defined as death within 4 weeks after surgery.

Radiotherapy course

Radiotherapy course

Instead of using catheters (which have to be fixed separately), a so-called flexible intraoperative template (FIT) was used to deliver a homogenous dose to a surface to which the shape of the mold is adjusted. This is a flexible 5-mm-thick silicone mold in which afterloader catheters are inserted parallel to each other at a fixed distance of 1 cm. The tumor bed was clipped by the surgeon, and the FIT was shaped and fixed to the target area. After inserting dummy catheters, orthogonal x-rays are made of the implant and loaded into the planning system. The treatment plan is generated with the indicated active dwell positions of the catheters. The radiation is delivered during remote-controlled anesthesia. A single radiation fraction of 10 Gy was administered, specified in a plane parallel to the surface of the FIT at 1-cm distance (1.25 cm from the catheters) with the MicroSelectron high-dose rate Ir afterloader.

After the external beam radiotherapy course, three patients dropped out of the protocol because of progressive disease resulting in an nonresectable tumor. We planned for the thoracic inlet resection in combination with intraoperative radiotherapy in 23 patients. Thoracotomy revealed that two patients had no chest wall invasion; these patients only had adhesions to the chest wall not requiring a chest wall resection, and therefore intraoperative radiation was considered not beneficial and thus not performed.

Finally, 21 patients (12 women and 9 men) underwent the entire planned treatment schedule, including resection and intraoperative radiotherapy. Their mean age was 58 years (range, 38 to 78 years). The preoperative clinical staging was stage IIB (all T3N0M0) in 18 patients, and stage IIIB (all T4N0M0) in 3 patients.

Diseases Help: Influenza Vaccination

Why are so many adults with asthma not being vaccinated for influenza? In part, this appears to be a generic failure to achieve vaccination coverage. The Healthy People 2010 objectives indicate that 90% of adults aged > 65 years should receive annual influenza vaccination, irrespective of chronic condi-tions. Based on the article by Ford and colleagues, the prevalence of vaccination is substantially lower among adults > 70 years old, including both adults with (68.4 to 75.7%) and without asthma (65.0 to 68.6%). Consequently, the failure to vaccinate appears to be part of a general failure to deliver recommended health-care interventions. Influenza Vaccination

There are also some potential barriers to vaccination that may be specific to asthma. In particular, the safety of influenza vaccination in adults with asthma has been debated. A randomized controlled trial of influenza vaccine conducted with 262 asthma patients revealed a greater risk of asthma exacerbation, manifested by a > 20% fall in peak expiratory flow rate, in the vaccine group compared to placebo Generic viagra. A larger-scale, randomized controlled trial of 2,032 adults with asthma, however, found no evidence of asthma exacerbation after influenza vaccination.

Influenza vaccination had no adverse effect on a variety of safety outcomes: peak expiratory flow rate, oral corticosteroid use, bronchodilator rescue therapy, and unscheduled health-care utilization. Further strengthening the case for vaccine safety, a large multicenter cohort study of children with asthma found no evidence of adverse asthma health outcomes following influenza vaccination. Although influenza vaccine appears to be safe in patients with asthma, it remains possible that perception of vaccine safety still poses a barrier to vaccination, either among health-care providers or the general public.

The efficacy of influenza vaccine for adults with asthma has also been questioned. A systematic review concluded that there was inadequate evidence to evaluate the efficacy of influenza vaccine for persons with asthma. In fact, there have been very few randomized controlled trials evaluating influenza vaccine among asthmatics. The existing trials are limited by small sample size, limited statistical power, and inconsistent quality. Perhaps the lack of specific randomized control trial data is another explanation for low influenza vaccination coverage.

There is substantial indirect evidence, however, that influenza vaccine is beneficial for persons with asthma. The efficacy of influenza vaccination in healthy adults and elderly adults has been firmly established by randomized controlled trials.

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Selection Criteria for Patients Participating in the Current SST Study

1) World Health Organization pathologic stage < 2.

2) The criteria for SST were fulfilled, ie, tumors arising in the pulmonary apex with invasion of the first, second, or third rib and pain in dermatomes C8, Th1, or Th2.

3) Cytologically or histologically proven non-small cell lung carcinoma stage T3N0-1M0 (IIB-ША) or T4N0-1M0 (IIIB). Mixed forms with small cell lung cancer were excluded.

For T4, extensive destruction of the vertebral body was considered as nonresectable (as seen on MRI).

4) No evidence of metastatic disease as assessed by physical examination, CT scan of the thorax and upper abdomen (liver and adrenals), bone scan, investigation of liver and adrenals by ultrasound, no longer than 4 wk before start of the treatment with Generic Viagra online.

5) Cervical mediastinoscopy was required for mediastinal lymph node staging within 4 wk of definitive start of treatment.

6) Informed consent was obtained.

7) No CNS involvement.

8) Horner syndrome is no contraindication for surgery.

The preoperative external beam radiotherapy consisted of 46 Gy in 23 fractions: 2 Gy per fraction, 5 fractions per week. The treatment was CT planned, and usually two anterior-posterior/ posterior-anterior fields were used. The target volume included the primary tumor, with at least 2-cm margin, the ipsilateral supraclavicular fossa, the whole vertebral bodies at the level of the primary tumor and the ipsilateral mediastinal lymph nodes. The cranial field border was usually placed above C6 and the caudal border at the level of the tracheal carina. In case of N1 nodes, the hilar region was also included. After radiotherapy, a new CT scan of the chest was made including the adrenals. If no progression was found, surgery was performed 4 to 6 weeks after the radiotherapy.

All patients were operated in the same institution by two experienced surgeons working in close collaboration with one of the radiotherapists. The SST was resected by means of a high extended posterolateral approach. In three patients with an anterior-mediastinal localization, a hemi-clamshell incision was carried out. The goal was a radical resection (R0) of at least the upper lobe en bloc with the chest wall. Only in the anterior chest wall resection, an artificial layer was used for reconstruction. For the posterior localization, the scapula was considered to be sufficient as a firm chest wall coverage. Postoperative mortality was defined as death within 4 weeks after surgery.

The pathologic diagnosis of the SST

The pathologic diagnosis of the SST was as follows: squamous cell carcinoma (n = 12), adenocarcinoma (n = 4), and large-cell undifferentiated carcinoma (n = 5). Three patients entered the protocol without definitive pathologic diagnosis before starting treatment, but the fine-needle aspiration showed malignant cells. In two patients after resection, only necrosis could be found in the surgical specimen; in the third patient, residual squamous-cell carcinoma was present.

Of the 21 patients who underwent a resection, three ribs were resected in 10 patients, four ribs in 6 patients, and five ribs in 2 patients. In 16 patients, a lobectomy was performed, 3 patients underwent bilobectomy, and 4 patients underwent pneumonectomy.

Because in most cases, the chest wall defect was covered by the scapula, in only seven patients (four patients with a large posterior, and all three patients with an anterior defect) a reconstruction was made using an artificial layer was used to obtain chest wall stability.

One patient died 1 week after the operation because of cardiac failure. The postoperative mortality is 1 of 23 patients (4%). Another patient was readmitted in the hospital with a bronchopleural fistula and sepsis, and died 7 weeks after surgery. Two patients had a prolonged hospital stay of > 3 weeks because of ARDS and pleural empyema; both recovered after intensive conservative treatment. In this retrospective analysis, no detailed information was available about functional morbidity and the use of analgesics.

In 21 patients, after a median follow-up of 18 months (range, 5 to 58 months), 8 patients were alive (37%), of which had no evidence of disease (median follow-up, 24 months; range, 6 to 58 months). Thirteen patients died, all but one with metastatic disease (63%). The first site of distant relapse was lung (n = 3), bone (n = 2), brain (n = 2), soft tissue (n = 2), and visceral (n = 2). The median survival after treatment Viagra Proffesional in Canada of SST for this group of patients was 14 months, and the median survival after distant relapse was 6 months (range, 1 to 15 months). At the end of the study, 18 patients (85%) were free from locoregional relapse (median follow-up of 18 months). All five patients who had a local relapse after 8 to 16 months (median, 11 months) underwent a R1 resection (macroscopic radical, but at microscopic examination no tumor-free margins). Two of them had a locoregional recurrence without distant metastases. The median survival of all patients with a relapse was 5 months (range, 1 to 15 months).