Priligy alternatives: what works and what to ask your doctor

If Priligy (dapoxetine) isn’t right for you, there are several other paths you can try. Some options are prescription medicines, others are simple techniques or products you can use with minimal cost or supervision. Below I’ll lay out the realistic alternatives, quick pros and cons, and safety notes so you can talk to your doctor with confidence.

Medical alternatives (drugs)

Many doctors use other medications when dapoxetine isn’t available or doesn’t work well.

• SSRIs (selective serotonin reuptake inhibitors) — Paroxetine, sertraline, and fluoxetine. These are taken daily and can delay ejaculation. Paroxetine tends to show the strongest effect, but side effects can include reduced libido, nausea, and tiredness. These require a prescription and a few weeks to take full effect.
• Tramadol — An opioid painkiller that can delay ejaculation in some men. It’s used off-label and can cause dizziness, drowsiness, and dependence. Avoid mixing tramadol with SSRIs without medical supervision because of serotonin syndrome risk.
• PDE5 inhibitors (sildenafil, tadalafil) — Mainly for erectile dysfunction, but they can help performance anxiety and improve control for some men. They don’t directly delay ejaculation the way SSRIs do, but combining them with other treatments can help.
• Topical anesthetics — Lidocaine or prilocaine creams and sprays numb the penis slightly, reducing sensitivity and delaying ejaculation. Apply as directed (often 10–20 minutes before sex), wash off or use a condom to avoid numbing your partner. Side effects are usually local numbness and occasional irritation.

Always discuss dosing and interactions with your clinician. Many of these drugs are prescription-only and need monitoring.

Non-drug options and practical tips

Drugs aren’t the only answer. Simple techniques and small lifestyle changes often improve control and satisfaction.

• Behavioral techniques — The stop-start and squeeze methods work for many guys. They teach you to recognize the point of no return and reduce sensitivity with practice.
• Condoms and desensitizing condoms — Thicker condoms or those with mild anesthetic inside can lower penile sensitivity and add a few extra minutes.
• Sex therapy and counseling — If anxiety, relationship issues, or performance fear are involved, a short course with a sex therapist often helps dramatically.
• Combination approach — Many men find the best results by pairing a low-dose SSRI or topical anesthetic with behavioral training and occasional PDE5 use. This can reduce side effects while improving control.

Quick safety notes: don’t self-prescribe tramadol or mix SSRIs with MAOIs. Topicals can numb partners if not used correctly. If side effects or mood changes appear, stop the drug and call your doctor. Be honest with your clinician about other meds, alcohol use, and any mental health history.

If you want, I can prepare a short list of questions to bring to your doctor or a printable comparison of these options. Which approach sounds closest to what you’d try first?