Psychiatry Tomorrow

The Psychiatrist Who Fought the FDA Over How Women's Desire Gets Measured | Anita Clayton, MD

Episode Summary

2-sentence description: Dr. Anita Clayton — UVA's chair of psychiatry and the researcher who built the field's standard scale for measuring antidepressant sexual dysfunction — joins Dr. Will Sauvé and Dr. Brittany Albright to trace a career spent proving what drug labels wouldn't say. From a fluoxetine label that said 1.9% when she was seeing 20% in clinic, to fighting the FDA over how women's desire gets measured, to the postpartum and depression treatments she's running trials on right now.

Episode Notes

Dr. Anita Clayton, chair of psychiatry at UVA and a former Navy physician, built the CSFQ — the validated scale now used across specialties to measure antidepressant sexual dysfunction — after noticing her fluoxetine patients' real rate of side effects was ten times what the drug's label claimed. In this conversation with Dr. Will Sauvé and Dr. Brittany Albright, she breaks down the three sources of sexual dysfunction clinicians routinely conflate: the illness itself, the medication, and the relationship strain that comes with depression. She explains why bupropion doesn't cause sexual dysfunction and can even rescue it from an SSRI, and the case she made to drug companies to stop hiding that fact. The conversation turns to flibanserin (Addyi), the first FDA-approved drug for low sexual desire in women, and the fight over regulators measuring female desire by a standard borrowed from Viagra trials — a saga now documented in the film The Pink Pill. Clayton also previews where she's headed next: zuranolone for postpartum depression, a single-dose psilocybin-analog injectable now being studied in adjustment disorder tied to serious illness, and gepirone ER (Exxua), a new antidepressant with no sexual-dysfunction warning at all. It's a career-spanning episode about what happens when someone refuses to accept "that's just how it's measured" as an answer.

 

Timestamped show notes

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