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2025

Standing Up To PE: The Dizzying Side of Priligy

Premature ejaculation, or PE, is one of those conditions that can carry a heavy psychological burden. It affects self-esteem, intimacy, relationships – it’s far more than just a stopwatch issue. So, when a patient comes in seeking help, there’s often a palpable sense of hope, especially when we discuss medications specifically designed to address it, like Dapoxetine, sold under the brand name Priligy. It offers a potential solution, a chance to regain control. But like many medications that work on brain chemistry and the nervous system, it requires careful usage and an understanding of its potential quirks.

I recently consulted with a young man, let's call him Alex. He was clearly distressed by his PE and eager to try Priligy after we discussed various options. During the consultation, I spent significant time explaining how it works (it’s a short-acting SSRI designed to be taken 'on demand' before intimacy) and, crucially, outlining the potential side effects.

"Alex," I explained, "like any medication, Priligy can have side effects. Some people experience nausea or maybe a headache. But one we really need to talk about is the possibility of feeling dizzy, lightheaded, or even fainting, especially when standing up." This is sometimes related to a drop in blood pressure or a vasovagal reaction. "To minimize this risk," I stressed, "it's vital you take the pill with a full glass of water, stay well-hydrated generally, and be careful about getting up too quickly after taking it, particularly if you feel any dizziness coming on."

He nodded, seemingly taking it all in, eager to get started. He left with his prescription and clear instructions.

A week or so later, I got a call from him. He sounded shaken. "Doc, I tried the Priligy last night," he began, "and... well, it kind of worked for the PE, I think? But afterwards, maybe half an hour later, I stood up from the couch and wow... the room just spun. I felt like I was going to completely black out. I had to grab onto the wall. It really scared me."

This wasn't an uncommon story, unfortunately. Pre-syncope, that near-fainting feeling, is one of the more concerning potential Priligy side effects.

"Okay, Alex, take a breath. Did you actually faint?" I asked.
"No, I managed to sit down quickly, and it passed after a minute or two. But it was intense."
"Let's backtrack," I said. "Did you take it with a full glass of water like we discussed?"
He hesitated. "Uh, maybe not a full glass. Just a swallow."
"And had you had much else to drink in the hours leading up to it? Water, juice?"
"Not really," he admitted. "We'd just had dinner, maybe a glass of wine earlier..." (Alcohol can potentially exacerbate these effects, though a single glass might not be the sole culprit).
"And when you stood up, was it quite quickly?"
"Yeah, I guess I just popped right up."

The picture was becoming clearer. Likely a combination of factors: possibly slight dehydration, taking the pill with insufficient water, maybe a minor contribution from the earlier alcohol, and then a rapid postural change – all conspiring to trigger that vasovagal response or orthostatic drop potentiated by the medication.

"Alex," I explained, "what you experienced sounds like a classic case of the dizziness or pre-syncope we talked about. It seems more likely to happen if you're a bit dehydrated or if you change positions too quickly after taking the medication. The Priligy can make your system a bit more sensitive to those shifts."

We then went back over the counseling points, but this time with the sharp reality of his experience reinforcing their importance. "The instructions aren't just suggestions," I reiterated gently but firmly. "Full glass of water with the pill. Stay generally hydrated. Be mindful of standing up – do it slowly, especially in the hour or two after taking Priligy. If you start to feel dizzy, sit or lie down immediately until it passes. Recognizing the warning signs is key."

We also discussed possibly trying a lower dose to see if it reduced the side effects while still providing enough benefit for his PE, but agreed to first try again with strict adherence to the hydration and postural advice.

Alex felt reassured understanding why it likely happened and having concrete steps to prevent it. His experience highlights that effective medication use isn't always just about swallowing a pill. For drugs like Priligy, it involves actively managing your body's potential responses through simple but critical behavioral adjustments. Ignoring those instructions doesn't just risk minor discomfort; it can lead to genuinely frightening episodes like Alex's, potentially derailing treatment altogether. Getting the best results often means working with the medication and its effects, not just taking it passively.

by Dr. Gregory J. Lowe on 2025-05-01 04:19:02