Because not all patients react in the same way to certain medications, selecting the so-called best is not really possible.
Among the oral drugs that have helped some men to overcome premature ejaculation, none is specifically approved for the treatment of PE, but they have side effects that make them useful in delaying ejaculation. MayoClinic.com says these drugs fall into three basic categories:
Antidepressants: Certain selective serotonin reuptake inhibitors, prescribed primarily to combat depression, have a tendency to delay orgasm. SSRIs that have helped fight PE include fluoxetine (Prozac and Sarafem), paroxetine (Paxil), and sertraline (Zoloft). If none of the SSRIs helps, your doctor might prescribe clomipramine, a tricyclic antidepressant sold under the brand name Anafranil.
Analgesics: Tramadol, sold under the brand name Ultram, is prescribed to relieve pain, but its side effects also delay ejaculation.
PDE5 Inhibitors: Although the primary purpose of these drugs is to restore erectile function, they do help some men to delay ejaculation.