On-demand modafinil improves ejaculation time and patient-reported outcomes in men with lifelong premature ejaculation

OBJECTIVE To evaluate the effects of modafinil on the intravaginal ejaculatory latency time (IELT) and patient-reported outcomes in patients with lifelong premature ejaculation (PE). PATIENTS AND METHODS Treatment-naive lifelong PE patients were included in this proof-of-concept study. Self-estimated IELTs of the patients were recorded and the Premature Ejaculation Profile (PEP) questionnaire was administered before the initiation of on-demand modafinil 100 mg treatment. At the end of 1 month of treatment, self-estimated IELTs were recorded again, along with posttreatment PEP outcomes. RESULTS Overall, 55 lifelong PE patients with a mean age of 35.07 +/- 7.80 (range: 22-58) years were enrolled. Modafinil treatment modestly increased the mean IELT at the end of 1 month (24.82 +/- 16.10 seconds vs 49.82 +/- 31.46 seconds, P =.0001). Moreover, at the end of 1 month, patients reported in the PEP questionnaire better control over ejaculation (0.75 +/- 0.67 vs 1.35 +/- 0.91, P =.0001), improved satisfaction with sexual intercourse (0.98 +/- 0.78 vs 1.40 +/- 0.85, P =.0001), lesser personal distress (0.42 +/- 0.69 vs 0.89 +/- 1.01, P =.0001), and reduced interpersonal difficulty (1.69 +/- 1.48 vs 1.95 +/- 1.47, P =.0001). CONCLUSION In an uncontrolled proof-of-concept study of men with treatment-naive lifelong PE where IELT was self-reported without a stopwatch, modest improvements of both IELT and patient-reported outcome measures were observed. Future controlled clinical trials are necessary to confirm these findings.