The antidepressant bupropion may hold promise for improving symptoms in younger women diagnosed with so-called hypoactive sexual desire disorder, a small study suggests.

The disorder, called HSDD for short, is diagnosed when a person has a persistently low interest in sex, and that disinterest is causing personal distress or relationship problems.

In the new study, Iranian researchers found that bupropion sustained-release (Wellbutrin SR) generally boosted sex drive among 116 women with HSDD who took the drug for 12 weeks. Compared with 116 women given an inactive placebo, their scores on a standard measure of sexual function were twice as high, according to findings published in the medical journal BJU International.

In some cases, low sex drive is related to underlying health conditions, like depression, or to side effects from some medications, like high blood pressure drugs or some antidepressants.

HSDD, however, refers to low sex drive that is not better accounted for by depression or other mental health disorders, and not caused by a medical condition or drug side effect.

As it stands, there is no treatment for HSDD that is widely accepted by women, according to the researchers on the new study, led by Dr. Mohammad Reza Safarinejad of Shahid Beheshti University in Tehran.

In Europe, a testosterone patch called Intrinsa is approved for treating HSDD in postmenopausal women. It is not approved in the U.S.

In an email, Safarinejad noted that studies have shown bupropion SR to improve sexual function in women who are having sexual side effects from using other antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

Decreased libido is a potential side effect of SSRIs, which include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac). Bupropion has a different mechanism of action from SSRIs, targeting the nervous system chemicals dopamine and norepinephrine rather than serotonin.

For the current study, Safarinejad and colleagues randomly assigned 232 women between the ages of 20 and 40 to take either bupropion SR or a placebo every day for 12 weeks. All of the women had been diagnosed with HSDD and were free of depression or other major health problems.

The study received no drug industry funding, Safarinejad said.

At the outset, both groups of women had similar scores on a standard questionnaire gauging sexual function -- just under 16, on average. The average score for healthy women with a regular partner is 33.6, Safarinejad said.

After 12 weeks, that score improved to 33.9 among women in the antidepressant group, versus 16.9 in the placebo group.

The most common side effects linked to bupropion included headache (affecting 9 percent of the group), insomnia and dry mouth (each affecting 7 percent), and nausea and muscle aches (each affecting 6 percent).

While the findings suggest that bupropion improves low sex drive, this is the first study to test the antidepressant in premenopausal women with HSDD.

"Further studies are needed to better elucidate the role of bupropion in HSDD," Safarinejad noted.

Exactly why bupropion might improve sexual function is unclear. One theory attributes the effects to enhanced dopamine and norepinephrine activity; research suggests that dopamine is a key player in the brain's "pleasure center," being released in response to "rewards" like food and sex.

                                                                                                                               2010-03-11

Does this sound like anyone you know? Darryl is 35, has a steady job, a stable home and good marriage, enjoys a few beers in front of the TV most nights -- doesn't have what most people would call a drink problem.

In the United States alone there are probably around 36 million Darryls, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which created the character, played by an actor on its website to help train doctors.

He doesn't exercise as much as maybe he should so he's a little overweight. At an average of four drinks a day, he is no alcoholic: but some experts now see him as a high-risk drinker and say he could succumb to "alcohol use disorder."

Millions more people across the developed world -- who drink a few glasses of wine every night after work or look forward to three nights of repeated shots with chasers on the weekends -- may today be adding up to a major health and social problem.

Could there be a pill to help them?

A reassessment of the nature of addiction, particularly to alcohol, is starting to pique Big Pharma's interest. For years the industry has been lukewarm, assuming either that finding a cure for alcoholism is impossible, or else that the target market -- homeless drop-outs, jobless bums and convicted drink drivers -- would not make for great returns.

Now changing western attitudes and cheap supermarket-supplied alcohol have made excessive drinking normal, including among the middle classes. Some experts predict the arrival soon of a new generation of drugs to help everyday drinkers.

"The potential market for medications that can be prescribed for these functional alcoholics is huge," said Mark Willenbring, an addiction expert and psychiatrist in the United States.

Just as with depression treatment 30 years ago, he says alcoholism research could be approaching a "Prozac moment" when it will become more natural, and more acceptable, for doctors to prescribe a pill to help people through a bad patch.

There are already drugs available to treat alcoholism, but their effects vary widely. As scientists' understanding of what alcohol does to our brain functions deepens, so, potentially, does the range of possible treatments.

Data from Thomson Pharma, a ThomsonReuters company that monitors the drug industry, show there are 24 drugs in development for alcoholism, including around 10 or more in mid-stage trials.

BIG BOOZERS ATTRACT BIG PHARMA

Drug giants Merck and Eli Lilly are the biggest hitters stepping up to the plate at the moment: each is pursuing two possible drugs through mid-stage human trials for treating alcoholism.

Biotech firm Alkermes is also very active in this area, with three drugs in development -- two new compounds, and the third a new format of an existing medicine.

As is often the case when drugmakers show renewed interest in an expanding concern, critics may accuse the firms of seeking to create a "new disease" to generate a market for otherwise unnecessary medicines.

But others argue the outcome could prove a lifeline to millions whose drinking presents a risk to their health, and a big bill to society.

"They don't need the intensity of treatment that more severe cases do," said Willenbring. "They don't need to go to alcoholics anonymous for the rest of their lives, they can respond well to some medication and brief behavioral support."

A woman's risk of heart disease and stroke in middle-age and beyond may be associated with the number of children she gives birth to, a large study of Swedish women hints.

"Women having two births had the lowest risk of future cardiovascular disease," Dr. Erik Ingelsson, at Karolinska Institutet in Stockholm, noted in an email to Reuters Health, while women having five or more births had the highest risk.

Prior studies looking at ties between number of births and women's later risk of heart disease have yielded conflicting results. Most of these studies were small. Ingelsson and his colleagues looked for an association between number of births and heart disease risk in 1.3 million Swedish women after they turned 50.

During follow up lasting up to 23 years (average of 9.5 years), more than 65,000 heart disease-related events such as heart attack or stroke occurred, the researchers report in American Heart Journal.

Compared with women who gave birth twice (the lowest risk group), women with no, one, or three births had about 10 percent greater risk of future heart disease. The risk was 30 percent higher in women with four births and nearly 60 percent higher in women with five or more births.

The investigators found similar risks when analyzing a subset of nearly 600,000 women with complete pregnancy and birth records and at least one birth between 1973 and 2005. Taking into account pregnancy complications such as high blood pressure and pregnancy-related diabetes, and birth-related complications did not explain the link between number of births and later heart disease and stroke risk.

Pregnancy leads to marked changes in how blood flows in and through blood vessels, which can alter risk for heart disease and stroke. Ingelsson and colleagues say a better understanding of these changes may lead to a better understanding of heart disease and stroke in women.

                                                                                                                                                                 2010-03-10