Gepirone-ER treatment of hypoactive sexual desire disorder (HSDD) associated with depression in women.

Abstract

INTRODUCTION:

There is currently no Food and Drug Administration (FDA)-approved treatment for hypoactive sexual desire disorder (HSDD). FDA approval of products utilizing testosterone has been delayed due to possible safety concerns. Flibanserin, a 5-HT(1A) agonist, 5-HT(2) antagonist, and gepirone-ER, a 5-HT(1A) agonist, have been shown to have activity in treatment of HSDD. However, more recently, the FDA issued a non-approval letter for flibanserin.

AIM:

To study the effect of gepirone-ER on HSDD in women with major depressive disorder (MDD).

METHODS:

At baseline and post-treatment visits, a trained psychiatrist made diagnoses of HSDD based on Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria. Subjects meeting criteria for HSDD were followed to observe the effect of gepirone-ER (20-80 mg/day), comparator antidepressants (fluoxetine, 20-40 mg/day or paroxetine, 10-40 mg/day), or placebo in reversing DSM-IV diagnosis. A subpopulation of women with Hamilton Depression Rating Scale (HAMD-17) entry scores of 18 or less was evaluated. Adverse events (AEs) of sexual dysfunction were also collected.

MAIN OUTCOME MEASURE:

Number (%) of patients who no longer met criteria for HSDD (percent resolved).

RESULTS:

Eight hundred seventy-five women (18-64 years of age, average 38 years old, ∼80% premenopausal) entered three studies; 668 (72.5%) completed. Only 161 (18.4%) met DSM-IV criteria for HSDD. Cumulatively, 63% of gepirone-ER-treated patients reversed their diagnosis of HSDD compared to 40% of placebo-treated patients at end point (8 weeks) (P = 0.007). Selective serotonin reuptake inhibitor-treated patients were not different from placebo. Significant results for gepirone-ER occurred by week 2 (P = 0.0001). Patients who were mildly depressed (HAMD scores of 18 or less) also improved at week 2 (P = 0.01) and week 8 (P = 0.07). Sexual dysfunction AEs were significantly less in gepirone-ER-treated patients than placebo (P = 0.013).

CONCLUSIONS:

Gepirone-ER may have efficacy in the treatment of HSDD among depressed and possibly nondepressed women. Efficacy occurs by week 2, and does not seem to be purely an antidepressant effect.

• Authors: Louis F Fabre, Candace S Brown, Louis C Smith, Leonard R Derogatis
• Journal: The journal of sexual medicine (J Sex Med) Vol. 8 Issue 5 Pg. 1411-9 (May 2011) ISSN: 1743-6109 [Electronic] Netherlands
• PMID: 21324094 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2011 International Society for Sexual Medicine.

Chemical References

• Antidepressive Agents
• Pyrimidines
• gepirone

Topics

• Adolescent
• Adult
• Antidepressive Agents (therapeutic use)
• Depressive Disorder, Major (complications, psychology)
• Double-Blind Method
• Female
• Humans
• Libido (drug effects)
• Middle Aged
• Pyrimidines (therapeutic use)
• Sexual Dysfunctions, Psychological (diagnosis, drug therapy, psychology)
• Treatment Outcome
• Young Adult