Description
Dapoxetine (Priligy)
Dapoxetine is the only SSRI developed specifically for on-demand treatment of premature ejaculation. What distinguishes it pharmacologically from other SSRIs is its short half-life — approximately 2 to 3 hours — which makes it suitable for single-dose use before sexual activity rather than daily maintenance dosing. Most SSRIs require weeks of continuous use to produce their delayed-ejaculation effect; dapoxetine works acutely. It’s licensed in the EU and numerous other markets under the brand name Priligy, though not in the United States.
Available in 30 mg and 60 mg tablets. A 90 mg strength appears in some markets; this exceeds the labeled doses in most licensed jurisdictions.
Dosing
30 mg taken 1 to 3 hours before planned sexual activity, swallowed whole with water. If 30 mg produces insufficient effect and was tolerated without significant side effects, 60 mg is the next dose. Maximum one tablet per 24-hour period. Clinical trial data shows the 60 mg dose approximately doubles ejaculatory latency time compared to placebo.
Not for daily use. Dapoxetine is not a continuous antidepressant treatment — it’s an on-demand medication. Taking it every day is not the intended or studied protocol.
MAO inhibitors
Dapoxetine combined with irreversible or non-selective MAO inhibitors carries serious risk of serotonin syndrome — a potentially life-threatening condition involving autonomic instability, hyperthermia, and neuromuscular abnormality. This combination is contraindicated. A washout period of at least 14 days is required after stopping an MAOI before using dapoxetine.
Alcohol
Dapoxetine should not be combined with alcohol. Both cause orthostatic blood pressure drops and CNS effects; combined use increases the risk of syncope and falls, particularly when changing positions quickly.
Contraindications
All MAO inhibitors. History of bipolar disorder or mania. History of drug or alcohol dependence. Hepatic insufficiency. Renal insufficiency. Significant cardiac disease. Thioridazine or linezolid co-administration. Age under 18.
Side effects
Nausea, headache, dizziness, and diarrhea are the most commonly reported, typically mild and transient. Orthostatic hypotension — dizziness or lightheadedness when standing — is the most clinically significant acute effect and is why patients are advised to sit or lie down for the first few hours after dosing if they experience this.
