VIDEO: What’s the role for flibanserin in sex dysfunction treatment?

WASHINGTON – Since the August 2015 approval of flibanserin for the treatment of hypoactive sexual desire disorder in premenopausal women, the drug has been under a cloud of controversy.

At the annual meeting of the American College of Obstetricians and Gynecologists, physicians debated the merits of flibanserin as a treatment option and whether the condition of hypoactive sexual desire disorder has been needlessly medicalized.

Dr. Holly L. Thacker, director of the Center for Specialized Women’s Health at the Cleveland Clinic, is supportive of the Food and Drug Administration’s approval of the drug and prescribes it in her own practice. She said it’s not effective for all women in treating low sexual desire. However, for women who do respond to the drug, it makes a significant difference in their quality of life, she said.

Side effects, which include syncope, have been overstated, Dr. Thacker added. “It’s very similar, if not lower in side effects, than other [central nervous system] drugs,” she said in a video interview.

But Dr. Adriane Fugh-Berman, an associate professor at Georgetown University in Washington, said in an interview that while low libido is a real and distressing problem for women and their partners, flibanserin is not a good treatment option, adding that its greatest effect is as a sedative. She said low libido is frequently a side effect of taking other medications, such as antidepressants, or results from stress, relationship problems, or boredom. Pyschosexual counseling and medication adjustment is often a better alternative, she said.

Dr. Fugh-Berman, who is also the director of PharmedOut, a research and education project on the effect of pharmaceutical marketing on prescribing practices, said the FDA’s approval of flibanserin was largely a result of an effective marketing campaign that emphasized the need for equity in treatments for sexual health between men and women. She disclosed that she is a paid expert witness in cases involving pharmaceutical marketing practices.

mschneider@frontlinemedcom.com
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