Addyi is a post-synaptic 5HT1A receptor agonist and 5HT2A receptor antagonist and has action in the central nervous system. Addyi affects three brain neurotransmitters: increasing dopamine and norepinephrine (both responsible for sexual excitement) while decreasing serotonin (responsible for sexual satiety/inhibition).
In 24-week Phase 3, placebo-controlled studies of premenopausal women, flibanserin demonstrated a significant increase in sexual desire, decrease in distress from the loss of sexual desire and an increase in the frequency of satisfying sex. Safety data showed the most common Side Effects were dizziness, nausea and sleepiness.
What is it for? – Flibanserin (brand name ‘Addyi’) is a medication which is used to treat Hypoactive Sexual Desire Disorder (HSDD) in women who have not gone through the menopause. HSDD is a condition where a woman has a ‘low libido’ (or ‘low sex drive/desire’) which causes them distress. The low sexual desire happens no matter who the partner or what the situation is.
What is it not for? – because it’s only for specific sexual dysfunction in women, Flibanserin is not used to treat low sexual desire if:
- It is caused by relationship problems, a lack of time, or a lack of energy
- It is caused by a medication that you take
- It is caused by a different medical or mental health condition
Flibanserin works on the brain – Flibanserin improves sexual desire by affecting the level of neurotransmitters in the brain. It does not work in the same way as male erectile dysfunction (ED) medication, which improves blood flow to the genital area – but it could be described as ‘Viagra for women‘ because it also treats sexual dysfunction. Also Flibanserin needs to be taken daily, whereas erectile dysfunction medications can be used on demand (only when needed).
It was developed as an antidepressant – historically, Flibanserin was actually developed as an antidepressant. Trials of the medicine found that, unfortunately, Flibanserin doesn’t work very well for this purpose. However, researchers noticed that patients who took part in the trial had increased libido. So, manufacturers hoped that Flibanserin could instead work to improve low sexual desire.
Research shows some success in treating low sex drive – studies which look at the effectiveness of Flibanserin found that it works; but only slightly better than dummy pills (placebo). Dummy pills are used in clinical research because people can have a response to taking a dummy when they think they are receiving treatment. So, these studies can tell us that some of the effects that people experience from Flibanserin are not because of the medicine itself.
Reviews of Flibanserin have been mixed – some say that the small improvement still brings significant benefits to relationships and quality of life, while others see it as aggressive marketing of a simplistic solution to women’s sexual dysfunction.
Flibanserin side effects – there are some side effects which are associated with using Flibanserin, including:
- Dizziness, feeling faint, or fainting
- Feeling tired
- Feeling sick (nausea)
- Feeling sleepy or sedated
- You have a condition that affects your liver. This affects the way that Flibanserin is processed in your body.
- You are pregnant or breastfeeding. There are currently no studies looking into the use of Flibanserin in women who are pregnant or breastfeeding so there is no way to know whether Flibanserin can be passed on to the baby through breast milk or harm an unborn baby.
- You drink alcohol. You are much more likely to experience the side effects of Flibanserin if you also drink alcohol.
Risks and benefits – also, because Flibanserin is a very new medicine, it is not possible to predict the long term effects of using the medicine. Part of the skepticism around Flibanserin as a medication is because the positive effects of Flibanserin are small, but the side effects can be stronger.
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