Comparative Evaluation of Safety and Efficacy of Dapoxetine, Silodosin, and Citalopram in the Management of Premature Ejaculation

Inclusion Criteria: * Diagnosis of PE according to Premature Ejaculation Profile Questionnaire (PEPQ) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-V-TR)\[12\]. * Persistent or recurrent ejaculation within approximately 1 minute of vaginal penetration (confirmed by stopwatch-measured IELT ≤60 seconds at baseline) * Inability to delay ejaculation during all or nearly all vaginal penetrations * Negative personal consequences (distress, frustration, avoidance of sexual intimacy) * PEPQ score ≥11. * Age ≥ 20 years. * In a stable, monogamous, heterosexual relationship for at least 3 months. * Signed informed consent indicating willingness to participate. Exclusion Criteria: * Use of PE medications in the preceding 4 weeks. * Use of hormonal supplements. * Patients with erectile dysfunction diagnosed by International Index of Erectile Function. * History of psychiatric or significant physical disorders (in either patient or partner). * Use of antidepressants, local anesthetic sprays, intracavernosal injections, or psychotherapy within 4 weeks. * Alcohol or substance abuse. * Documented hypotension.