Viglast, which is generally categorized as a fast-acting SSRI, was developed specifically to treat this condition. It may be effective at the first dose (ie, on demand) when given 1-3 hours before sexual intercourse, and its adverse-effect profile is comparable to those of other SSRIs. Viglast has been approved in a number of countries but not yet in the United States. In a study of men with both premature ejaculation and erectile dysfunction who were on phosphodiesterase type 5 (PDE5) therapy, Viglast provided treatment benefit and was generally well tolerated. However, up to 90% of patients discontinue Viglast, mostly because of adverse effects, cost, and disappointing efficacy.
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