Nonhormonal Pharmacological Treatment of Low Desire Interest

The place of pharmacological management for women's complaints of low desire/interest is undecided. This is because of broad normative range of women's appreciation of sexual desire, especially in the long-term relationship; and because of the importance of women's subjective arousal in influencing and triggering their desire and the minimal focus until now on the whole entity of subjective arousal. Thus, the appropriate outcome criteria for a "desire drug" are unclear. Studies with bupropion hydrochloride have suggested benefit over placebo. Of 30 women with active drug, 19 improved during a 12-week double blind placebo-controlled study for nondepressed women having a spectrum of sexual complaints, including low desire/interest (91). A more recent study, again of nondepressed women, this time diagnosed with hypoactive sexual desire, were treated in a single blinded manner and 29% responded to the active drug and none had responded to the initial 4-week placebo phase (14). The entity of sexual interest as well as sexual desire was monitored and shown to improve. Despite these two studies, the clinical experience is of limited benefit from this intervention. Larger placebo-controlled randomized studies of bupropion or other molecules that alter the neurotransmitters known to influence desire and arousability, including dopamine, serotonin, and noradrenaline, are needed.

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