What is Lexapro (Escitalopram)?
Lexapro (escitalopram) is an FDA-approved prescription medication primarily used for treating major depressive disorder and generalized anxiety disorder. It's a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain to help regulate mood. While primarily for mood disorders, a notable side effect has led to its use in another area.
The Link Between SSRIs and Sexual Function
SSRIs increase serotonin by blocking its reabsorption into neurons. Serotonin is involved in various bodily functions, including sexual response and ejaculation. A common side effect of many SSRIs is sexual dysfunction, such as decreased libido, difficulty with orgasm, and crucially, delayed ejaculation.
How Exactly Does Lexapro Help Last Longer in Bed?
Serotonin significantly influences the ejaculation reflex. Higher central nervous system serotonin levels are thought to inhibit this reflex. Lexapro, by increasing serotonin availability, can dampen the signals that trigger ejaculation, thereby potentially extending the time to orgasm. Delayed ejaculation was reported as a side effect by about 12% of men in Lexapro clinical trials. This observation has led physicians to use this effect as an off-label treatment for premature ejaculation (PE), where ejaculation occurs sooner than desired.
Evidence for Off-Label Use in Premature Ejaculation
Off-label use means prescribing a drug for a condition not listed on its official approval. Studies support SSRI use for PE. One study on escitalopram showed significant increases in intravaginal ejaculatory latency time (IELT). Other SSRIs like paroxetine and sertraline also show effectiveness, with paroxetine often considered very potent for delaying ejaculation. Lexapro for PE is typically taken daily and not just before sex. Effects may start in several days to over a week, with full results potentially taking multiple weeks.
Potential Side Effects and Risks
While delayed ejaculation can be a desired effect for PE, it is still a side effect. Other potential sexual side effects include reduced libido, erectile dysfunction, and difficulty reaching orgasm. Non-sexual side effects like nausea, drowsiness, and headache can also occur, often improving over the first few weeks. Long-term SSRI use might also negatively impact semen parameters. Consult a healthcare provider before considering Lexapro for PE to assess suitability and monitor effects.
Comparison Table: Lexapro vs. Other PE Treatments
| Treatment | Mechanism of Action | Effectiveness | Prescription? | Common Side Effects |
|---|---|---|---|---|
| Lexapro (SSRI) | Increases serotonin levels in the brain. | Can increase ejaculation time significantly with daily use. | Yes. | Decreased libido, ED, anorgasmia, nausea, drowsiness. |
| Sertraline (SSRI) | Increases serotonin levels in the brain. | Significant increase in ejaculation time; can be used daily or on-demand in some cases. | Yes. | Similar to Lexapro; may include fatigue, dry mouth, diarrhea. |
| Topical Anesthetics | Numb the glans penis to reduce sensitivity. | Can increase ejaculation time by several minutes. | Some are OTC, others prescription. | Penile numbness, potential for transference to partner, burning sensation. |
| Behavioral Techniques | Teaches control over the ejaculatory reflex (e.g., Start-Stop, Squeeze). | Varies; requires practice and partner cooperation. | No. | No physical side effects; may cause frustration. |
| PDE-5 Inhibitors | Primarily treats erectile dysfunction; can improve confidence and perceived control. | May help when PE is comorbid with ED. | Yes. | Headache, facial flushing, indigestion. |
Alternatives to Lexapro for Lasting Longer
Other options for managing PE include:
- Other SSRIs: Paroxetine and sertraline are also used off-label for PE.
- Topical Anesthetics: Creams or sprays containing lidocaine or prilocaine can reduce penile sensitivity.
- Behavioral Methods: Techniques like 'start-stop' or 'squeeze' help build control over the ejaculation reflex.
- Pelvic Floor Exercises: Strengthening these muscles may offer more control.
- Tramadol: A pain reliever with a side effect of delaying ejaculation, but it shouldn't be combined with SSRIs and has dependency risks.
Conclusion
Lexapro can help you last longer in bed due to its effect on serotonin levels, which can delay ejaculation. This is an off-label use that must be discussed with a healthcare provider, considering potential side effects like reduced libido and other sexual dysfunctions. It requires a prescription and medical oversight. Individuals with PE should explore all treatment options, including behavioral approaches and other medications, with a doctor to find a safe and effective solution.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting or stopping any medication.
