(423) A Case Series of Successful Off-label Use of Flibanserin

Abstract Introduction Flibanserin was the first FDA approved drug for hypoactive sexual desire disorder (HSDD) in premenopausal women, but initially studied as an antidepressant without concern age or gender. acts partial agonist at serotonin receptor 1A and antagonist 2A receptor. The mechanism of action is thought to be due increase dopamine norepinephrine. Post hoc analysis during pivotal trials showed improvement not just desire, all domains Female Sexual Function Index (FSFI) including orgasm, arousal, lubrication satisfaction. Off label use flibanserin therefore interest medicine providers. Objective Described here, are four off uses with successful outcomes patient’s symptoms quality life, post-orgasmic illness syndrome (POIS), low libido a eugonadal male, postmenopausal female HSDD, patient post-finasteride (PFS). Methods case 40-year-old male who presented 10 year history acquired POIS, significantly debilitating lasting 1 week after orgasm. After trying number different multimodal treatment approaches he finally on regimen Bupropion, Lexapro, Silodosin, Ritalin Tramadol reduction duration his from 4 days, change symptom intensity. Patient then trialed 200mg gabapentin nightly 100mg nightly, progressive discontinuation prior medications. second patient, 77-year-old hypersexual, woman significant trauma history, gradually worsening HSDD despite adequate estring, started nightly. 3 51-year-old mild erectile dysfunction normal testosterone levels minimal improvements sildenafil, fourth involves 26-year-old presenting PFS dysfunction, decreased libido, genital shrinkage, testicular pain, anxiety brain fog. had some erections post finasteride, only able achieve full erection tadalafil. 2 months flibanserin. Results All these patients experienced their starting 1, markedly reduced intensity POIS 7 days day. regained life within 2-3 months. Lastly, marked sleep, fog, function. Conclusions These cases indicate that may useful more than women should medication additional pro-sexual affects like bupropion buspar. Disclosure No