Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 6/23/2021
Medications for depression, anxiety and a host of other mood disorders have been shown to be effective in helping people feel their best.
They’re an effective treatment for out-of-balance brain chemistry — but what about sexual chemistry?
Believe it or not, there’s some pretty convincing evidence out there to suggest that some of these medications may be effective in treating sexual dysfunctions like premature ejaculation.
Paxil® is one of these medications.
Before we discuss this more complicated issue, though, we need to lay out a few facts.
Paxil (generic name paroxetine) is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA to treat a variety of mood disorders.
Paxil is prescribed to treat major depressive disorder, OCD, generalized anxiety disorder and others.
It can be prescribed both as a time-release tablet, as well as in liquid form — both should be taken orally.
Side effects of Paxil may include things like drowsiness, excessive sweating and change in appetite.
They may also include weight gain, constipation, diarrhea, skin and dermatological issues, dizziness and more.
Paxil should not be taken alongside monoamine oxidase inhibitors (MAOIs), thioridazine or pimozide — it can lead to some huge problems, including serotonin syndrome or arrhythmias.
But wait! There’s more.
In addition to its use in treating mood disorders, Paxil is also occasionally prescribed off-label for premature ejaculation.
That may seem random, but, believe it or not, it’s not the only mood disorder medication used to treat these conditions.
As we mentioned before, Paxil is part of a classification of antidepressants called selective serotonin reuptake inhibitors (SSRIs).
SSRIs prevent the brain from reducing the available supply of serotonin. That means that more serotonin remains in your system for the stuff you actually need serotonin for (regulating mood).
SSRIs can be effective for treating depression, which is thought to be caused by serotonin imbalances (what causes the imbalances is another story).
So, where does premature ejaculation come in? Well, under the radar. Technically, SSRI regulation of PE issues isn’t an intended use of the medication.
As the tech nerds among us would say, it’s a “feature.”
SSRIs aren’t primarily designed for this kind of job, but many of them are label-validated by the FDA to treat conditions beyond depression.
Delayed ejaculation is a common side effect of SSRI medications and prescribed by providers (off-label ) for men who suffer from premature ejaculation.
It’s probably a good idea to touch on what premature ejaculation is. Contrary to what the movies might suggest, PE is not simply being quick on the trigger, or short-lived in bed.
PE needs to meet certain requirements for a diagnosis. According to the World Health Organization, PE symptoms can be described as, “… persistent or recurrent ejaculation with minimal stimulation before, on or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and / or his partner bother or distress…”
It’s also more common than you might think. PE is one of the most common conditions affecting men, alongside another sexual dysfunction: erectile dysfunction.
Studies show that as many as 39 percent of men may suffer from some degree of PE.
Sound familiar? You might have PE issues. So what do you do about them?
Unfortunately, there’s no one central cause to all PE issues. Science has linked or correlated many things to PE, but an actual cause remains elusive.
But there are risk factors the medical community agrees on, most of them biological or psychological.
Biological issues include inflammation of the prostate or urethra, abnormal hormone levels or serotonin levels. Some experts believe serotonin can regulate ejaculation speed.
Psychological factors might include mood disorders like depression and anxiety, excessive stress, as well as unrealistic performance expectations or an overall lack of confidence.
But things like body image, relationship issues, guilt or a history of sexual abuse or repression might also contribute to the problem (as well as to other problems like erectile dysfunction).
You or someone else might be suffering from a variety of these issues, which is why it’s difficult to pin down exact causes.
SSRIs have shown a lot of promise in the treatment of premature ejaculation.
A 2007 study involving 100 “normally potent” men who were given three different SSRIs found that 100 percent of the men experienced significant increases in their Arab Index of Premature Ejaculation (AIPE) scores, which is the standard used to gauge PE severity.
But Paxil has had some spotlight of its own.
A study of nearly 100 men with PE showed that when Paxil was taken both daily and as-needed three to four hours before sex, it lead to an increased ejaculation latency time.
What’s going on behind the scenes here is that delayed ejaculation is actually a side effect of taking certain antidepressants (including Paxil).
Furthermore, Paxil was shown in some studies to be more effective than other SSRIs like prozac and lexapro.
It performed as well as some other medications, including lidocaine gel, zoloft, PDE5 inhibitors and zoloft.
Unfortunately, PE is not “curable.” But as a chronic condition, there are several ways to address the problem.
Physiological strategies like the start-stop technique are employed in real-time to address the immediate urge to ejaculate during sex.
As you might suspect, the root of this technique is stopping when you feel the urge, and then starting once it passes.
Kegels for men are a great sexual exercise generally; the goal of this exercise is strengthening the muscles of the pelvic floor, which can help you control ejaculation urges more effectively.
The “squeeze technique” (Yup. That’s a real thing.) suggests that squeezing the tip of the penis for about 30 seconds to decrease arousal can also help you regain control.
It’s been shown to be effective, but may require repeating several times in one session.
Gels, creams and other solutions abound — read more about the other treatments for PE in our guide.
Whether Paxil is your best friend in the bedroom is going to depend on your unique biochemistry — and don’t look at it as a potential problem-solver in lieu of actually talking to a healthcare professional about PE.
Premature ejaculation isn’t going to go away without attention, and it likely will require the attention of both yourself and a healthcare professional.
We know it can be hard to talk about this stuff, but you want professional help in your corner to guide you to the right treatment.
That may be Paxil, or another SSRI, or a holistic approach focusing on things like diet and exercise, stress or anxiety.
Maybe it’ll be a combination of the above.
It may be scary to think about addressing the problem, but we can assure you it’s not nearly as scary as living out the rest of your life with the same fears.
Address them and do it soon, so you can start enjoying your sex life again.