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what does ritalin look like ?

you can see the pictures blow ( tablets and blisters )

Ritalin comes in small pills, about the size and shape of aspirin tablets, with the word “Ciba” (the manufacturer’s name) stamped on it.  10 mg tablets are pale green, and the 20 mg tablets are both white . It is described as a central nervous system stimulant.


ritalin online

ritalin online


ritalin online

Ritalin (Methylphenidate) (MPH) novartis

You can buy ritalin online on

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Brexit: Shockwaves to AstraZeneca, Novartis, GlaxoSmithKline

Business Finance News believes It is too early to comment on the effects of Brexit on the pharmaceutical arena in European Union and the UK

The astonishing verdict by the UK people to cut ties with the European Union (EU) has put pharmaceutical companies such as AstraZeneca plc (NYSE:AZN), Novartis, and GlaxoSmithKline in a rollercoaster as the European Medicines Agency (EMA) has to be relocated from London to other cities in Europe. EMA plays a distinct role in the regulation of the clinical trials and approval of drugs for the EU members. The association of Germany’s pharmaceuticals industry said that the relocation of the EMA will bring multiple administrative problems for the pharmaceutical industry.

With Brexit’s voting results, manufactures will be in hot water as they will face a long-lasting impact for the approval of the drug and multiple hurdles in initiating the clinical studies. Pharmaceuticals and medical devices contribute a major chunk in the UK exports to the EU. According to the UK Trade and Investment board, the life sciences sector generates revenue of $80 billion annually.

GlaxoSmithKline plc (NYSE:GSK) representative said: “Although the EU Referendum result creates uncertainty and potentially complexity for us in the future, we do not currently anticipate a material adverse impact on the business, Group’s results or financial position. We will continue to operate as usual and will engage in the process ahead. We look forward to working closely with all relevant stakeholders. Our priority continues to be ensuring patient access to our medicines, vaccines and consumer products across the world.”

In addition, GSK expects that Brexit’s impact on the global market will be not so unfathomable, but it will definitely put its slight impression on the UK pharmaceutical industry in terms of investment, research, and jobs opportunities.

AstraZeneca’s spokesman said it is completely UK’s choice, but we think enduring with EU will be more beneficial for the patients and industry. The spokesman added that the company respects the decision of the referendum.

Alexion Pharmaceuticals, BioMarin, and Amgen have shown a dip of 9%, 8%, and 4%, respectively due to their major exposure to the European market.

For the last four decades, the pharmaceutical companies in Europe were working in a systematic manner and have an integrated portfolio beginning from the research and development and finales at commercialization of the drug in the therapeutic market. After the announcement of the results, GlaxoSithKline and AstraZeneca are still uncertain whether to shift their head offices from the UK.

EMA will have the major impact of Brexit as it has a fulltime staff of 600. Since 1995, the agency has been involved in the approvals of multiple drugs, which will be marketed in EU member countries. According to the EMA spokeswoman: “It is too early to foresee the implications of this decision and at this stage, we are waiting for further guidance from the European Commission (EC).”

Despite EMA officials are waiting for further progress from the EC, multiple countries such as Sweden, Denmark, Italy, and Germany have shown their keen interest in establishing the EMA head office in their territories.

EMA has 33 members of national associations and 40 leading pharmaceutical companies. In addition, it exemplifies 1,900 EU companies involved in the research, development, and manufacturing of novel molecules for the management and treatment of multiple therapeutic areas.

Despite the transfer of the EMA head office to other location, UK does not face any critical problem, as it has regulatory agency by the name of Medicines and Healthcare products Regulatory Agency (MHRA).

In the UK, National Institute for Health and Care Excellence (NICE) plays a vital role in conserving the drug price factor. The agency is interlinked with European network for Health Technology Assessment (EUnetHTA), who is responsible for the data influx regarding the price factor in the EU. With the implementation of the voting that might take more than two years, NICE will not be able to get the data influx from EUnetHTA and will be in hot water in order to testify the drugs’ price factor in the UK.

Currency Impact

The impact of the currency will be limited as expected, because majority of the pharmaceutical companies are established in the US and Asia. GlaxoSmithKline has a positive scenario after Brexit result and is of an opinion that it will not affect its business, but on the other hand, it will give benefit due to the volatile pound sterling in the days to come. Other companies such AstraZeneca will not be affected by the referendum decision as they are dealing in US dollar. Approximately, 70,000 people are involved in the pharmaceutical sector in the UK, which encompasses 25% of the total research and development in the country.

New Drugs Approval

After the exit, the UK drugmakers have to become the European Economic Area in order to get the fastest drug approval as Norway, Liechtenstein, and Iceland are implicating. With the membership, UK will have an access to the EMA for single marketing authorization to launch the drugs throughout Europe, but they will not be entitled for the operational entities of EMA.

On the other hand, if the UK does not adopt the aforementioned process, it will be difficult for the pharma industry to get authorization of the drugs in a simple fashion.

Drug Pricing Factor

In the UK, drug pricing is a type of voluntary agreement between the pharmaceutical industry and the government. Both the entities mutually set the drug’s price for five years. The UK pricing mainly depends on the external reference price of other EU countries and then finalize the price keeping in view EU’s situation.

The UK is also a member of EU Joint Procurement Agreement, which gives the liberty to the countries for the procurement of drugs in the case of a cross-border health emergency.

Leaving the EU will put immense pressure on the UK pharmaceuticals as the majority of clinical trials and launch of new drugs in the UK will become cumbersome. The majority of the pharmaceutical companies are of the opinion that Britain will have to remain in the EU chapter.

According to the pharmaceutical industry, Britain has been involved in approximately 40% of rare disease trials covering the whole EU segment. After the decision, the region will lose some of the clinical trials.

On the other hand, officer bearers of the National Eczema Society also elaborated that they were intimated by the two US companies that their eczema drug trial will not be initiated in the UK due to Brexit decision.

Despite all the drawbacks, UK pharma segment will be freed from the EU and EMA. British government has an excellent opportunity to implement its own strategic policy for the research and development of drugs. According to the GlobalData, it will be a tough time for Britain to maintain the same level of excellence in the research and development of its participation in external programs such as Horizon 2020.

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Have you had trouble using a credit card to purchase medications from an international online pharmacy lately? You’re not alone. Unfortunately, this problem won’t be going away any time soon. Companies like Visa and Mastercard have joined the Center for Safe Internet Pharmacies (CSIP), an alliance of organizations that aims to protect people from rogue and unsafe online pharmacies. Unfortunately, CSIP’s definition of a “safe online pharmacy” takes a broad-based approach and rejects any based outside the United States.

We agree that consumer protections are critical. Consumers should be wary when ordering medications online because there are rogue entities out there selling counterfeit medicine. But safe and legitimate international online pharmacies also exist. More importantly, they offer dramatic savings (50-80 percent) to American patients struggling to afford their needed medicines. Because what good is a medicine if you can’t afford it?

LegitScript is steering the course of CSIP. This private company certifies online pharmacies for safety and they have an FDA contract for $5.2 million to provide “Internet monitoring of illegal online pharmacies.” Their mission is: “promoting safety and transparency for online pharmacies and health products.” But their guidelines require that a pharmacy be located in the United States and that drugs are FDA approved if selling into the U.S.

Canada and other international pharmacies often sell the exact same drugs that get at home with the only difference being the packaging. And of course, these meds are not “FDA approved” because each country has its own system for regulating pharmaceuticals (some arguably safer than our own).

The good news is that international online pharmacies are offering customers the ability to pay for their medications by check. Of course, this may mean that payments take longer to process and medication shipments are delayed, which is never good for patients. Please keep this in mind when planning your next order.

Remember, we have tips for finding a safe international online pharmacy on our website.

reference :

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Dr Dukan Diet Plan

Drop 10 pounds in one week and never gain it back. You can do it if you follow the Dukan Diet’s rules, claims French general practitioner and nutritionist Pierre Dukan, who created the diet in 2000.

Dukan Diet Phases

Most diets help you lose weight. But 95% of people who diet gain all the weight back… and more when they return to their old eating habits.

The Dukan Diet will redesign your eating habits and help you permanently stabilise your weight.

The Dukan Diet is a high protein, low fat, low carb diet – a healthy eating plan based on proteins and vegetables, 100 foods in total. And what’s best, it’s “EAT AS MUCH AS YOU LIKE.”

The distinct Dukan Diet 4 Phases will help you Lose and Stabilize your Weight

The Dukan Diet does not guarantee extreme results in record time.  Instead it promises that if you follow the instructions you will be able to reach your True Weight, a realistic weight that you can attain & maintain for the rest of your life.

(Weight Loss results may vary).

Calculate Your True Weight.

The Dukan Diet 4 Phases

1. The ATTACK Phase: to jump start your weight loss.

The Attack phase consists of pure protein and creates a kick-start to the diet. During this phase, you can eat 68 high-protein foods that produce immediate and noticeable weight loss.

2. The CRUISE Phase: to reach your True Weight.

The Cruise phase adds 32 vegetables and will take you to your True Weight. In total, you can select from 100 Natural Foods. You will gradually but steadily lose weight by alternating Pure Protein days and Protein + Vegetables days. The average length of this phase is based on a schedule of 3 days for each pound you want to lose.

3. The CONSOLIDATION Phase: to prevent the rebound effect.

images-dukanDuring this time you are at your most vulnerable, as the body has a tendency to quickly regain weight. The Consolidation Phase is designed to prevent the rebound effect by gradually returning previously forbidden foods in limited quantities and allowing for up to two “celebration” meals per week. This phase follows a strict timeline – 5 days per every pound lost in Cruise Phase. It is important to follow one other important step once the Consolidation Phase has begun – a pure protein day on Thursday.

4. The STABILISATION Phase: definitely crucial, for life

Fresh appetizing apple and brightly colored dumbbells tied with a measuring tape. Slight reflection, white background, focus on the apple

The Stabilisation phase is the rest of your life! You have learned how to eat healthier in the previous phases and have developed a pattern to follow.  In addition, to keep your new slim body, you must follow these three simple but non-negotiable rules:

  • 3 Tablespoons of Oat Bran per day
  • Walk 20 minutes daily and choose to take the stairs whenever possible
  • Have a pure protein Thursday, i.e. Attack Phase menu.

Most people will regain the weight they lost as soon as they reach their goal weight. The Dukan Diet method creates a complete program that goes beyond just the weight loss phases. Two phases are devoted completely to the maintenance of your True Weight: the Consolidation and Stabilization phases. The last phase, Stabilization, is probably the easiest but also the most important.

Choose from
68 proteins
+ 32 vegetables
+ fruit, starchy foods, whole grain bread, and cheese
include foods from all food groups
Expected weight loss
between 2 to 8 pounds during the phase
2 lbs per week on average
between 2 to 7 days
about 3 days per pound
about 5 days per pound lost in Cruise
For life
Amount of oat bran (Tablespoon/day)
Physical activity(duration/day)
20 min
30 min
25 min
20 min


Example Attack Phase Menu


When you first read about the Attack Phase it appears to be quite a simple diet to follow.  When you have 72 different foods you can chose from and which you can eat without limitation it feels as if you couldn’t possibly fail, especially when you know that this phase will give your diet a real kick start.

The challenges which get overlooked include:

  • Eating 1 1/2 tablespoons of oat bran each and every day.
  • Restricting yourself to just 4 egg yolks per week if you have problems with raised cholesterol or 7 egg yolks if not.
  • Having variety in what you are eating.

Well if you are only following the Attack Phase for two or three days you may not find it too hard.  You could probably eat the same food each day, allowing yourself one egg each day and eat your oat bran in a yogurt but what happens after that.   You need to remember that you will be having protein only days every other day throughout the Cruise Phase so I believe that it is important to start your diet as you mean to go on and build in as much variety as possible.  To help give you some ideas you do this I will be putting together seven example Protein only menus which together will use only just over 4 egg yolks in the 7 days and will provide your daily serving of oatbran without you having to put it in your yogurt.

Day 1 Protein Only (1 1/3 egg yolks)


  • 1 Boiled Egg
  • 1 piece Dukan Toast (1/2 tbsp oat bran) made with just egg whites
  • Zero fat Vanilla Yogurt


  • 1 Oat Bran Muffin (1 tbsp oat bran) 1/3 egg


  • Oven Baked Salmon Fillet
  • Zero fat Cottage Cheese


  • Tandoori  Chicken Fillet
  • Sugar-free Jello (This requires a little lateral thinking to fit in.  I see it as a diet drink with gelatine that makes it set.  If preferred you could have another yogurt instead but the Jello has less calories! )
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Swiss pharmaceutical company mulling investment in Iran

Swiss pharmaceutical company mulling investment in Iran

Tehran,  Head of the association of Iran-Swiss mutual investment said Monday that following a visit to Iran of Swiss economic delegation, well-known Swiss pharmaceutical company Novartis is mulling investment in Iran.

Speaking exclusively to IRNA, Hossein Salimi said that Novartis has examined capacities of Iranian market and decided to make investment in Iran.
Novartis is a multinational company based in Basel, Switzerland and is one of the biggest pharmaceutical corporations.
Referring to the visit to Tehran by the Swiss delegation, Salimi said that given the economic slowdown across the Europe, a lot of the European countries are mulling investment in Iran.
Salimi said that during their stay in Tehran, the Swiss economic delegation met with high-ranking Iranian officials and visited a number of companies and industrial units of the countr
Novartis is cooperating with Iranian company Modava in production of some of it’s product like Ritalin.
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Tramadol HCL

Tramadol HCL is a centrally acting synthetic opioid analgesic, (pain killer)
which relieves moderate to severe pain such as pain following surgery, hip
replacement or other bone and dental surgery. This drug also helps relieve
chronic pain associated with cancer, nerve pain or low-back pain.
in general, combine with the opioid receptors in the brain to block
the transmission of pain signals. The cause of the pain may remain, but less pain is actually felt.
Tramadol comes alone or in combination with acetaminophen, combination brands are:
Ultracet, Padolten and Zaldiar, which contain Tramadol 37.5mg and acetaminophen 325mg.

Brands of Tramadol only include: Tramacip, Tramadolor, Ultram, Zytram and others.
Tramadol is available in various forms, including capsules, tablets, orally dispersible tablets,
(sublingual) extended release, gradual release (ER or Retard) and IV injections.

Ordering options for Tramadol, including Padolten and other Generics are below.
No prescription is needed, some pharmacies will require a consultation via questionnaire to
enable their staff physician to issue a prescription (this is always a free consultation).


Buy Generic Ultram or Tramadol and Ultracet

No Prescription Needed for Opioid Analgesics

Tramadol is a synthetic opioid analgesic (pain killer) that
relieves pain by acting directly on the central nervous system.

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This is Basic Information about Methylphenidate ( Ritalin , Stimdate … ) you can either post a new topic or reply to … Click Ask a question to post a new question to our community . .



Stimulants excite the nervous system and increase physiological function.

Read more on TripSit Wiki…


These drugs pose a higher risk of causing habit forming behaviour, take particular care with the amount and frequency they are taken.

Read more on TripSit Wiki…


Common drugs are those which are well known and widely used among the drug community. This doesn’t necessarily mean they are safe, but it usually comes with a longer relative history of use in humans with which to establish a safety profile.



Onset30-120 minutes
Duration2 hours
Onset5-15 minutes
Duration1 hours


EffectsIncreased alertness, Euphoria, Increased motivation, Reduced appetite, Flushing of the face, Increased body temperature, Tachycardia (Increased heart rate) Paranoia, Insomnia.



  • αMT
  • Tramadol
    • Tramadol and stimulants both increase the risk of seizures.
  • MAOIs
    • MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.


  • DOx
    • The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.
  • NBOMes
    • Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.
  • 2C-T-x
    • Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
  • 5-MeO-xxT
    • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
  • DXM
    • Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
  • PCP
    • This combination can easily lead to hypermanic states


  • Mushrooms
    • Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
  • LSD
    • Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
  • DMT
    • Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
  • Mescaline
    • The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops
  • 2C-x
    • The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.
  • Cannabis
    • Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
  • Ketamine
    • No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
  • MXE
    • Risk of tachycardia, hypertension, and manic states
  • Cocaine
    • This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine
  • Caffeine
    • This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.
  • Alcohol
    • Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.
    • Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
  • Opioids
    • Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Low risk & Increased Effects

  • N2O
  • MDMA
    • Amphetamines increase the neurotoxic effects of MDMA

Low risk & Decreased Effects

  • Benzodiazepines
    • Both can dull each other’s effects, so if one wears off before the other it’s possible to overdose due to the lack of counteraction

Low risk & No Synergy

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Study shows ‘brain doping’ is common in amateur sport

brain-doping razidrug

What is brain enhancement?

So called “smart” drugs that can improve mental function have become popular in recent years. A number of substances have been developed that can improve concentration, attention, memory and cognition.

Methylphenidate: Known by the brand names Ritalin and Concerta among others. It is a psychostimulant used to treat attention deficit hyperactivity disorder (ADHD). Prescriptions for these drugs increased by 50% in the six years from 2007.

Modafinil: This medicine is used to treat the sleep disorder narcolepsy. The drug helps people stay awake and improves alertness and the ability to concentrate.

Aking substances to enhance the brain is more popular among amateur athletes than taking drugs to boost the body.

Researchers in Germany found that 15% of recreational triathletes admitted to brain doping, using prescription medicines that increase attention.

Some 13% of competitors reported using physical enhancers like steroids or human growth hormone.

Brain doping is more popular say the scientists, because many of the substances aren’t banned.


The research has been published in the journal Plos One.

Previous studies have shown that, among amateur competitors, the use of performance-enhancing substances is widespread.

This new work used the responses of almost 3,000 triathletes taking part in events in Germany, to analyse the broader picture of physical and cognitive doping.

Researchers believe that many so-called “smart drugs” are being widely used to enhance mental functions outside the patients groups they have been designed to help.

They are also concerned that competitors in a variety of sports may be using these substances to gain an edge.


Previous studies have shown that, among amateur competitors, the use of performance-enhancing substances is widespread.

This new work used the responses of almost 3,000 triathletes taking part in events in Germany, to analyse the broader picture of physical and cognitive doping.

Researchers believe that many so-called “smart drugs” are being widely used to enhance mental functions outside the patients groups they have been designed to help.

They are also concerned that competitors in a variety of sports may be using these substances to gain an edge.


“There is some searching for additional help, we found a strong connection between those taking legal cognitive enhancers and those taking illicit ones,” said Prof Simon.

“There seems to be a certain proportion of our society that is willing to take a bit more of a risk to gain an advantage.”


The authors believe that the sporting status of cognitive enhancement may be affecting the attitudes of some of these amateur sports participants.

Athletes are aware that physical doping is forbidden and drug testing is common in triathlon competitions, including amateur ones.

However the use of cognitive substances is not associated with sanctions and therefore abusing them may seem a lesser infringement.

The researchers believe this reflects attitudes in society where the taking of ADHD medicine doesn’t carry the same stigma as using steroids.

The authors say their research leaves many unanswered questions about brain doping.

Prof Simon said: “On the cognitive level, we don’t know enough about these substances. Is there is a hyper performance effect?”

“What we know is that if you are a patient you are going to perform better than before, but if you are already a high-level performer we don’t know if there is an effect. That’s the big question.”

The researchers warn that, regardless of the enhancement, abusing brain doping substances can have damaging impacts in the long run.


A question of substance

The authors accept that getting to a precise definition of what constitutes doping is difficult. They tried to be as clear as possible in their questions on the different types of enhancement.

Physical doping: Have you used substances which can only be prescribed by a doctor, are available in a pharmacy, or can be bought on the black market (such as anabolic steroids, erythropoietin, stimulants, growth hormones) to enhance your physical performance during the last 12 months?

Cognitive doping: Have you used substances which can only be prescribed by a doctor, are available in a pharmacy, or can be bought on the black market (such as caffeine tablets, stimulants, cocaine, methylphenidate, modafinil, beta-blockers) to enhance your cognitive performance during the last 12 months?






























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What Ingredient Is in Fake Cocaine?

ketamine cocaine razidrug

They usually mix : a local anesthetic (lidocaine )

+  An inhalation anesthetic (ketamin) + amphetamines (methylphenidate )+ fillers (caffeine..)

to be continue  …..

The most widely used stimulants are

  • caffeine (in coffee, tea, and cola beverages)
  • nicotine (in cigarettes)
  • amphetamines
  • cocaine

Local Anesthetics

These chemical relatives of cocaine act by blocking the voltage-gated Na+ channels of sensory neurons preventing them from generating action potentials. [Discussion] They are injected or applied topically and block transmission not only in pain-conducting neurons but in others as well (causing general numbness).


  • lidocaine
  • procaine

Inhaled Anesthetics

Most of these are volatile hydrocarbons or ethers. Diethyl ether and chloroform are seldom used today, having been replaced by safer alternatives such as isofluorane, a fluorinated ether.

Some, like isofluorane, bind to inhibitory GABA receptors) in the brain hyperpolarizing, and thus decreasing the sensitivity of, postsynaptic neurons.

Others, like ketamine, block the activity of excitatory glutamate receptors.

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Female Viagra not covered on most insurance plans …

insurance viagra razidrug


Michelle Weber says that when her boyfriend wanted to take Viagra, his insurance paid for it, no questions asked.

So when she wanted to take the new “female Viagra” for her sexual problems, she figured that would go smoothly, as well.

But it didn’t.

Her insurance company refused to pay for the drug, called Addyi, saying she’d have to see a psychiatrist first.

“They don’t tell men who want Viagra that they have to see a psychiatrist,” said Weber, 38, who asked that her real name not be used, in order to protect her and her boyfriend’s privacy.

Indeed, they don’t, say doctors who treat sexual dysfunction.

And these doctors say the psychiatrist requirement is just one of many “barriers” that insurance companies have put in place for women, but not men, who are seeking drugs to treat sexual problems.

“It’s a huge double standard,” said Weber’s gynecologist, Dr. Tami Rowen, an assistant professor of obstetrics and gynecology at the University of California-San Francisco.


Dr. Irwin Goldstein, a sexual health specialist in San Diego for both men and women, said insurance companies have routinely rejected his prescriptions for Addyi, but that’s never been the case for Viagra.

“It’s startling. It’s so sexist,” said Goldstein, the president of the International Society for the Study of Women’s Sexual Health, who has been a paid consultant to the pharmaceutical companies that make both Addyi and Viagra.

In addition to the psychiatrist requirement, Weber’s insurance company, Blue Shield of California, refuses to pay for Addyi unless a woman first tries another, less expensive drug, according to the company’s prescribing guidelines.

That less expensive drug isn’t approved to treat sexual problems and can have devastating side effects.

Blue Shield gave Weber a third reason it wouldn’t pay for Addyi, according to a letter it wrote her. The company said it wouldn’t pay because her low libido appeared to be a side effect of a medication she’s taking.

Weber said Blue Shield must have been referring to the only drug she takes: a type of antidepressant known to have sexual side effects for both men and women.


But she said she suffered from low libido even when she wasn’t on an antidepressant.

“And I’d love to know, do they tell men they can’t have Viagra because they’re on antidepressants?” she asked.

CNN sent Clinton McGue, a Blue Shield of California spokesman, an email with this question. He responded that “without knowledge of the member’s detailed history or the case,” he could not provide more of a response.

When asked about the Addyi denials, a spokeswoman for the insurance industry responded that some studies have shown Addyi isn’t very effective and can have side effects.

“If there’s a question mark around a coverage decision, that usually means there’s a question mark around the efficacy,” said Clare Krusing, a spokeswoman for America’s Health Insurance Plans. “This drug failed two FDA reviews prior to being approved, and the reason it got approved the third time is because of a broad PR campaign by the company that makes it.”

That explanation doesn’t sit well with doctors who treat sexual dysfunction. They say the FDA ruled last year that Addyi, which is taken every day, is safe and effective. The doctors add that the drug doesn’t work for all women, but it certainly works for some.

“I think women in general should be alarmed. Insurance companies are covering things for men that they’re not covering for women,” said Dr. Alyse Kelly-Jones, a gynecologist in North Carolina.

Doctors said the “double standard” they see for women with sexual problems manifests in other ways, too.

They said insurance typically pays for their older male patients to take testosterone to boost their sagging sex lives. But when older women want treatments for vaginal dryness and atrophy, insurance companies usually balk.

Krusing disagreed, saying major insurance companies do cover such treatments.


But gynecologists cite denial after denial for such drugs.

Dr. Laura Hirshbein, associate professor of psychiatry at the University of Michigan, said she’s dismayed but not surprised that insurance companies are often refusing to pay to treat women with sexual problems.

Hirshbein, who studies issues of gender, sex and psychiatry, said men with erectile dysfunction get a multitude of treatment options, which are often celebrated in giant advertising campaigns.

“Men get told they can expect to function sexually and can expect to easily get whatever they need in order to do that,” Hirshbein said.

But she said that historically, women have been told that if they have sexual problems, they must be mentally ill.

“Women are told it’s all in their head,” she added.

In March, when Weber received her Addyi prescription from her gynecologist, she unsuspectingly headed to the pharmacy to fill it.

The pharmacist came back with the news: Her insurance company wouldn’t pay for it. She could pay for it herself — to the tune of $1,000 a month.

No, thank you, Weber said, and walked out empty-handed.

Blue Shield’s McGue said in a statement that “a committee of external pharmacists and physicians, including psychiatrists, review the medical evidence for prescription medication to determine Blue Shield’s coverage policy,” he wrote. “The committee determined that Hypoactive sexual desire disorder is best diagnosed after a psychiatric evaluation.”


But doctors said other specialists, such as gynecologists and sexual health experts, have the training and experience to identify and treat sexual problems, not psychiatrists.

“I’m a sexual health expert. This is my niche,” said Rowen, Weber’s gynecologist. “And they’re telling me I can’t diagnose a sexual disorder? That’s crazy.”

Hirshbein, the psychiatrist at the University of Michigan, agreed. She said that when her patients suffer from sexual dysfunction, she sends them to doctors who have more experience in that area.

“I’m a psychiatrist. I wouldn’t write a prescription for [Addyi], in the same way I wouldn’t write a prescription for Viagra,” she said.

In his statement, McGue also mentioned “the serious safety concerns associated with Addyi [which] include adverse effects of the central nervous system.”

Addyi has a “black box warning” highlighting the increased risk of low blood pressure and fainting when combined with certain other drugs or with alcohol.

The less expensive drug that Blue Shield requires women try before taking Addyi has a black box warning of its own.

Bupropion, also known as Wellbutrin, has a warning highlighting the risk of developing “serious neuropsychiatric symptoms,” including suicidal thoughts.

“That makes no sense,” said Kelly-Jones, the gynecologist in North Carolina. “For Wellbutrin to be considered first-line therapy for something it’s not FDA-approved to treat, that’s concerning.”

Since getting the rejection from Blue Shield in March, Weber has been on a mission.

She did get a prescription from a psychiatrist and marched it into the pharmacy a few weeks ago.

The pharmacist came back with more news: Blue Shield had rejected it again, saying she needed more documentation from the psychiatrist.

Weber calls the whole situation ironic.

Her boyfriend doesn’t need Viagra, she says. He can have sex without it. He wants it so he can have longer-lasting erections, hoping that might make her happier.

“I’m the one with the actual disorder. I’m the one with no sex drive at all. But he’s the one who walks out of the doctor’s office with a prescription that he can actually fill,” she said.

As she tries to increase her libido — she sees a certified sexologist for help — she hopes her relationship will survive.


She explains to her boyfriend that she doesn’t know why she has a low libido, but she knows it has nothing to do with him or his sexual performance.

Even with the reassurances, she’s not sure their relationship will survive her lack of interest in sex.

“We’re thinking about getting married. It’s really serious. But a big piece of it isn’t working, and that’s hard for both of us,” she said.



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