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L-Arginine Alpha-Ketoglutarate is a powerful amino acid compound that plays a crucial role in enhancing blood circulation within the body. â Another user noted, âI was skeptical at first, but after consistent use, I can genuinely say Health Charm has transformed my performance both in and out of the bedroom.â A review of escitalopram (a long-acting SSRI) included 1 study (30 participants), which found a significant improvement in IELT compared with placebo.34 The same review also found a significant increase in IELT scores for duloxetine (a serotonin and norepinephrine reuptake inhibitor [SNRI]) and a topical anesthetic (eutectic mixture of local anesthetics). The vast majority of pharmacologic interventions for PE were reported to significantly increase IELT. AMSTAR 2 assessments identified several methodologic weaknesses across all included reviews (see Appendix 3). Number/percentage of reviews which addressed the respective interventions. 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