This week, the FDA approved Flibanserin, the first-ever drug for female sexual dysfunction. Everyone’s calling it female Viagra. The other everyone is pointing out that the drug, being sold under the brand name Addyi, works nothing like Viagra. Flibanserin is obviously big news. But, the little pink pill's arrival to the lady-arousal party aside, Flibanserin is not some miracle drug — it’s nothing more than a mediocre antidepressant.
Viagra is a sexual dysfunction drug: Men take the little blue pills before sex to increase penile blood flow and enable sexual performance. Flibanserin is a sexual desire drug: Women have to take the little pink pills every day, as the drug supposedly enhances libido by tinkering with levels of neurotransmitters in the brain — you know, like antidepressants do.
In fact, the drug was initially developed as an antidepressant by pharma company Boehringer Ingelheim, but didn’t pass muster in clinical trials. The one area in which it did seem to make a difference, based on trial participants’ input, was in lifting sex drive. Sprout Pharmaceuticals decided to reformulate the drug as a libido stimulator. Even in its reincarnation as a sex-drive drug, Filbanserin only did so-so in trials. Still, five years later — with help from the gender rights' equality group "Even the Score," and most likely Big Pharma suits who recognized the first female sexual dysfunction drug as the PR and financial goldmine it is – he we are.
Chemically speaking, Flibanserin is being considered an NDDI (Norepinephrine-dopamine disinhibitor), meaning it increases levels of two key neurotransmitters: norepinephrine and dopamine. Right now, the only other NDDI is Agomelatine, which is sometimes prescribed for major depressive disorder. Flibanserin also appears to decrease levels of serotonin.
While not in the same family, the popular antidepressant Wellbutrin also acts on norepinephrine and dopamine. A lot of women report increased sex drive after popping Wellbutrin, semi-cheekily dubbed the “skinny, happy pill.” Doctors do sometimes prescribe Wellbutrin off-label to jump-start a less-than-smoldering libido. So why hasn’t it been officially approved as a sexual dysfunction drug? Well, for one, it’s really hard to untangle sexual desire and mood.
As reported in a 2010 Haper’s Bazaar story, in which the author noticed a renewed interest in sex after taking Wellbutrin:
“In women, though, there are factors other than aging when it comes to sexual desire and function. "They're very complicated things," [the author's doctor] Friedman says. "Many physical factors can contribute to decreasing libido. But as your body ages, there are social changes that can affect your mood and your self-esteem too." So for many women, it's hard to know which came first—a downturn in mood or in sexual interest. It's not entirely clear to me whether my own issues were the result of depression, or the cause of it, or just concurrent with it.”
So, why not; go fill that Filbanserin prescription once it hits shelves in October. If the daily pink pill fails to ignite any sexual flame, here’s a plan b: Hop over to the psychiatrist and strike up a convo about depression. Female sexual dysfunction shouldn’t become a new euphemism for a mental disorder. Maybe you’re not in the mood, or maybe you’re battling low moods. Either way, it’s okay.