Flibanserin is a medication primarily used to treat hypoactive sexual desire disorder (HSDD) in pre-menopausal women. HSDD is characterized by a persistent lack of sexual desire that causes distress or interpersonal difficulty. Flibanserin is marketed under the brand name Addyi and works by targeting certain brain chemicals involved in sexual desire.
Key Points About Flibanserin:
1. How Flibanserin Works:
Flibanserin is thought to work by modulating neurotransmitters in the brain, specifically serotonin, dopamine, and norepinephrine. These chemicals play a role in regulating mood, arousal, and desire. Flibanserin:
Increases dopamine and norepinephrine levels, which are associated with sexual desire.
Decreases serotonin levels, as high serotonin is thought to suppress sexual desire.
Flibanserin’s action is not based on directly stimulating physical sexual arousal but rather on modulating brain activity to enhance desire and interest in sex.
2. Indication:
Flibanserin is prescribed to pre-menopausal women who experience hypoactive sexual desire disorder (HSDD), defined by:
A low sexual desire that causes distress.
No other underlying medical or psychiatric conditions (i.e., the low desire is not due to another cause, like medication side effects, depression, or relationship problems).
It's important to note that flibanserin is not indicated for men or for the treatment of sexual desire loss due to other causes, such as aging, menopause, or medical conditions like diabetes.
3. Dosage:
Flibanserin is typically taken as a once-daily pill, usually at bedtime to minimize the risk of side effects like dizziness or drowsiness. The typical starting dose is 100 mg per day.
Important: It’s critical that Flibanserin be taken at bedtime to reduce the risk of side effects, particularly hypotension (low blood pressure) or syncope (fainting), which may occur if taken during the day.
4. How Long Does It Take to Work?:
Flibanserin is not an instant solution. It can take several weeks of daily use (often 4 to 8 weeks) before any significant changes in sexual desire or function are noticed. This gradual onset of effects is different from many other medications that target sexual function.
5. Side Effects:
While Flibanserin can be effective for improving sexual desire, it does have a range of possible side effects. Some of the common side effects include:
Dizziness
Drowsiness or fatigue
Nausea
Headache
Insomnia
More serious but rarer side effects include:
Low blood pressure (hypotension)
Fainting
Sleepiness, especially when combined with alcohol or certain other medications.
6. Precautions and Warnings:
Alcohol: Flibanserin has a serious interaction with alcohol. Drinking alcohol while taking Flibanserin can increase the risk of severe side effects, including dangerously low blood pressure and fainting. Women should avoid alcohol completely while on the medication.
Liver Function: Flibanserin should be avoided in women with severe liver impairment. For those with mild to moderate liver issues, a dose adjustment may be necessary.
Drug Interactions: Flibanserin can interact with other medications that affect the central nervous system, such as:
CNS depressants (e.g., benzodiazepines, alcohol, sedatives)
Strong CYP3A4 inhibitors (e.g., certain antifungals, HIV medications)
Oral contraceptives (as they may affect how the body metabolizes flibanserin)
7. Effectiveness:
Clinical studies have shown that Flibanserin can significantly improve sexual desire and reduce the distress related to low sexual desire in women with HSDD. However, the effect is modest:
On average, women using flibanserin experience about 1 extra satisfying sexual event per month compared to those using a placebo.
While it is effective, Flibanserin is not a cure-all for low sexual desire and should be part of a comprehensive approach that includes addressing any psychological, relationship, or medical factors contributing to sexual dysfunction.
8. FDA Approval:
Flibanserin was approved by the FDA in 2015 under the brand name Addyi for the treatment of HSDD in pre-menopausal women. However, its approval was controversial due to concerns about its efficacy and potential risks, particularly the interactions with alcohol.
Summary of Flibanserin (Addyi):
Flibanserin (Addyi) is a medication designed to treat hypoactive sexual desire disorder (HSDD) in pre-menopausal women by targeting brain chemicals involved in sexual desire. It works by balancing levels of serotonin, dopamine, and norepinephrine, helping increase sexual desire. However, it's not for everyone — it should not be used if alcohol consumption is frequent, and it’s not recommended for women with severe liver issues.
Key points to remember:
Daily use at bedtime is required for effectiveness.
Takes time to work, often 4-8 weeks.
Avoid alcohol while on the medication to prevent severe side effects.
Side effects include dizziness, drowsiness, nausea, and headaches.
As with any medication, it’s important to consult with a healthcare provider before starting Flibanserin to ensure it’s appropriate for your situation.