Flibanserin: The first drug approved for the treatment of hypoactive sexual desire disorder in pre-menopausal women

• Published in: European psychiatry Vol. 33; p. S734
• Main Authors: Couto, N, Ribeiro Silva, R
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.03.2016
• Subjects: Internal Medicine; Psychiatry
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2016.01.2190

Introduction Hypoactive sexual desire disorder (HSDD) is characterized by persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity, causing marked biopsychosocial dysfunction. The etiology of HSDD involves a wide range of biological and psychosocial factors. One of the biological factors is the balance between excitatory and inhibitory neurotransmitter pathways that regulate the sexual response in the central nervous system. Flibanserin is a compound discovered in 1995, agonist of the 5-HT1A antagonist and the 5-HT2A receptors, which became August 2015 in the first drug approved for the treatment of HSDD. Objectives Describe the main pharmacokinetic and pharmacodynamic characteristics of flibanserin, as well as the results and conclusions of the phase three clinical trials that led to its approval by the US regulatory authority. Aims To understand the potential benefits and risks of the clinical use of flibanserin. Methods Search online titles and abstracts related to flibanserin. Results Flibanserin is a multifunctional serotonin agent who is both a serotonin 1A agonist and a serotonin 2A antagonist. Theoretically, flibanserin improves sexual activity by increasing dopamine and norepinephrine release as it reduces serotonin release in brain circuits that mediate the symptoms of interest/female sexual arousal. Flibanserin showed a statistically significant increase in the number of improvements and satisfactory sexual events in several other validated scales. The main side effects include dizziness, sleepiness, nausea and (rarely) syncope. Conclusions Despite the efficacy of flibanserin not produce statistically powerful results, although statistically significant, this may be important for a particular woman's profile, including those in which other psychotherapeutic approaches have failed.