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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by phidippus on August 19, 2015, at 21:26:09
Did Flibanserin fail to get FDA approval as an antidepressant? Flibanserin acts as a full agonist of the 5-HT1A receptor (Ki = 1 nM) and, with lower affinity, as an antagonist of the 5-HT2A receptor (Ki = 49 nM) and antagonist or very weak partial agonist of the D4 receptor (Ki = 424 nM). Nefazadone strikes as being very similar.
Posted by Phillipa on August 20, 2015, at 9:38:56
In reply to Flibanserin or the 'pink pill', posted by phidippus on August 19, 2015, at 21:26:09
It's approved for Female sexual desire disorder in premenopausal only females.
Posted by phidippus on August 20, 2015, at 10:59:47
In reply to Re: Flibanserin or the 'pink pill' » phidippus, posted by Phillipa on August 20, 2015, at 9:38:56
Yeah , but it's a 5ht2a antagonist and 5ht1a full agonist. I could easily seeing it being used as an adjunct for depression.
Eric
Posted by Phillipa on August 20, 2015, at 11:39:27
In reply to Re: Flibanserin or the 'pink pill' » Phillipa, posted by phidippus on August 20, 2015, at 10:59:47
That was the initial plan and it was shot down? I received a RN newsflash on this med last night.
Posted by Phillipa on August 20, 2015, at 11:44:55
In reply to Re: Flibanserin or the 'pink pill' » Phillipa, posted by phidippus on August 20, 2015, at 10:59:47
Eric you probably already read this but here is the FDA approval from yesterday. Phillipa
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm
Posted by Hello321 on August 20, 2015, at 14:07:57
In reply to Re: Flibanserin or the 'pink pill' » phidippus, posted by Phillipa on August 20, 2015, at 11:44:55
"Only available through certified prescribers and pharmacies"
I wonder what type of prescribers/pharmacies are more likely to be certified. I did read they had to undergo certain training to be certified to prescribe it. I dont like this, it seems like its just a barrier making it difficult to get prescribed, especially off-label. But i guess it is better to be safe than sorry in some cases.
Posted by phidippus on August 21, 2015, at 9:39:42
In reply to Re: Flibanserin or the 'pink pill', posted by Hello321 on August 20, 2015, at 14:07:57
The most serious side effects include severely low blood pressure and loss of consciousness. These risks are increased when patients drink alcohol or take certain medicines that interfere with the breakdown of flibanserin in the body. That means doctors will have to consult with a patient and assess whether abstaining from alcohol is possible.
Apparently all the hoops you have to jump through are warranted.
Eric
Posted by Phillipa on August 21, 2015, at 10:00:34
In reply to Re: Flibanserin or the 'pink pill' » Hello321, posted by phidippus on August 21, 2015, at 9:39:42
Eric definitely no alchohol at all with this med
Posted by Hello321 on August 21, 2015, at 14:32:12
In reply to Re: Flibanserin or the 'pink pill' » phidippus, posted by Phillipa on August 21, 2015, at 10:00:34
Ok, in this article it says it is just a slide show doctors have to watch, and then take a test before they can prescribe it. So it doesnt seem that difficult, and maybe one could just ask their doc to get certified if they arent already, so their doc can prescribe it for them
http://mobile.nytimes.com/2015/08/19/business/fda-approval-addyi-female-viagra.html?referrer=
Posted by phidippus on August 23, 2015, at 17:20:42
In reply to Re: Flibanserin or the 'pink pill', posted by Hello321 on August 21, 2015, at 14:32:12
I just wonder if they'll prescribe it off-label for other psychiatric needs.
Eric
Posted by Hello321 on August 23, 2015, at 18:39:47
In reply to Re: Flibanserin or the 'pink pill' » Hello321, posted by phidippus on August 23, 2015, at 17:20:42
I suppose that will just depend on the doctor. My current MD let me try Belviq, a weight loss med thats a 5ht2c/2a agonist, for mood problems. He said no at firs. that if i ever get it prescribed, it would need to be done by a psychiatrist. Then my psychiatrist told me itd have to be prescribed by an MD. I went back to my MD and he ended up prescribing it. He knew how treatment resistant ive been. But im sure you know some docs are difficult to work with and some arent.
Then again, you might have better luck getting it prescribed if you claim sexual problems, even if you dont. Flibanserin is intended to treat the desire part of the sexual response in females. But im sure it should about as helpful in males, and your doc should realize this if hes a decent doc. If not, you might have yo teach him a thing or two.
Posted by Phillipa on August 23, 2015, at 19:08:55
In reply to Re: Flibanserin or the 'pink pill', posted by Hello321 on August 23, 2015, at 18:39:47
Just premenopausal females and the rate of response compared to placebo isn't very high. Means you just be willing to have sex maybe l time more in a time period that fits what you have been doing. Think it's a sham
Posted by phidippus on August 23, 2015, at 19:12:20
In reply to Re: Flibanserin or the 'pink pill', posted by Hello321 on August 23, 2015, at 18:39:47
What's your current regimen?
I'm pretty skeptical about Flibanserin. I don't think libido is governed by 5ht receptors, as is evident by the efficacy of Cyproheptadine, which is a serotonin blocker.
Eric
Posted by Hello321 on August 24, 2015, at 13:47:48
In reply to Re: Flibanserin or the 'pink pill' » Hello321, posted by phidippus on August 23, 2015, at 19:12:20
> What's your current regimen?
>
> I'm pretty skeptical about Flibanserin. I don't think libido is governed by 5ht receptors, as is evident by the efficacy of Cyproheptadine, which is a serotonin blocker.
>
> EricIm currently taking Viibryd and Adderall. Just started taking the Viibryd, so no effect from it yet.
And im not sure i get any benefit from Adderall anymore.But, im pretty certain my serotonin receptors have played a major role in my libido and condition on a whole. Cyproheptadine is the only med that has ever truly benefitted me. It brought me from being catatonic and with zero libido to being able to live a mostly normal life with a sex drive, until it stopped working. And my experience with Buspar, it actually had a negative effect on my libido, while many people experience improvement in that area with Buspar. And it is said this effect is from the 5ht1a partial agonism at the postsynaptic receptor, which when stimulated, results in an increase in dopamine release. But i believe Buspar had a negative effect on me with its stimulation at the presynaptic receptor, where i do believe it is a full agonist. Im pretty sute the presynaptic receptor causes a decrease in dopamine release, and that it had too little effect at my postsynaptic receptor.
And when it comes to Cyproheptadine,i believe its inverse agonism at the 5ht2c receptor brought all my pleasurable emotions back. This receptor inhibits dopamine, but when blocked, your brain is more free to react to pleasure by releasing dopamine.
So.... i wouldnt be too skeptical about the serotonin receptors having control over libido. And i think Flibanserin would be worth a try for libido and mood problems.
Posted by phidippus on August 24, 2015, at 14:25:21
In reply to Re: Flibanserin or the 'pink pill', posted by Hello321 on August 24, 2015, at 13:47:48
>i wouldnt be too skeptical about the serotonin receptors having control over libido.
Yes, what I meant to say is blocking serotonin seems beneficial for libido but agonism or reuptake inhibition does not, with the exception of the 5ht1a receptor-and I think this has to do with the fact oxytocin release is stimulated by agonism of the 5ht1a receptor.
Eric
Posted by Hello321 on August 30, 2015, at 2:09:51
In reply to Re: Flibanserin or the 'pink pill' » Hello321, posted by phidippus on August 24, 2015, at 14:25:21
Heres an interesting article
This is the end of the thread.
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