Clomipramine is a trycyclic antidepressant developed in the 1960s and has been in wide clinical use since for a number of disorders including depression, OCD and narcolepsy. It was also first discovered to be a potential cure for premature ejaculation by Eaton in 1973.
Daily Dose
Most studies have investigated the use of clomipramine when taken as a daily dose. One found a 25 mg bedtime dose to be effective in a single case[1]. Another study showed better performance than placebo when a course of 6 weeks was taken[2]. Yet another study showed mixed results: a daily dose of between 10 and 40 mg over 2 months showed no benefit versus placebo. However, after this double-blind period patients received clomipramine for 3 months and nearly half derived benefit[3].
On-Demand Dose
Studies have also been carried out into the efficacy of clompiramine when used “on demand”, several hours before intercourse.
One study found that a 25mg dose taken 12 to 24 hours before intercourse derived was effective for men with premature ejaculation alone (but not erectile dysfunction). Average IELT (intravaginal ejaculatory latency time) increased from an average of 2 to 8 minutes[4]. Another study encountered similar results with the same dose but also found a common side effect of nausea the following day[5].
Other studies have investigated a range of doses of between 10 and 50 mg taken between 4 and 24 hours before sex.
SSRIs
Medical professionals are now more likely to prescribe a newer class of antidepressants, SSRIs, both generally and for premature ejaculation. This is because SSRIs are considered to be just as effective and have fewer side effects and lower lethal doses. The most effective SSRI for premature ejaculation has been shown to be paroxetine.
1. http://www.jstor.org/pss/3812838
2. http://www.ncbi.nlm.nih.gov/pubmed/6751156
3. http://www.ncbi.nlm.nih.gov/pubmed/7193614
4. http://linkinghub.elsevier.com/retrieve/pii/S0022534701655769
5. http://linkinghub.elsevier.com/retrieve/pii/S0302283804002702
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