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Augmentation with naltrexone to treat compulsive sexual behavior: A case series

Nancy C. Raymond, MD

Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

Program in Human Sexuality, Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA

Jon E. Grant, JD, MD

Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

Program in Human Sexuality, Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA

Eli Coleman, PhD

Program in Human Sexuality, Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA

BACKGROUND: Compulsive sexual behavior (CSB) is generally characterized by recurrent and intense sexually arousing fantasies, sexual urges, and behaviors, which cause individuals distress or impair daily functioning. Descriptive studies of individuals with paraphilic and nonparaphilic CSB indicate that they experience urges to engage in problematic sexual behavior. The opiate antagonist naltrexone has been successfully used to treat a number of disorders in which urges to engage in problematic behavior are a central feature, such as alcoholism. We hypothesized that naltrexone would reduce the urges and behaviors associated with CSB.

METHODS: Records of 19 male patients with CSB who were treated with naltrexone at an outpatient adult sexual health clinic were retrospectively reviewed.

RESULTS: Nearly all patients were already taking other psychotropic medications when naltrexone was initiated. Seventeen (89%) of the 19 patients reported a reduction in CSB symptoms when taking naltrexone for a period ranging from 2 months to 2.3 years, as judged by Clinical Global Impression scores of 1 or 2, indicating “very much improved” or “much improved.” Five (26%) of the 19 patients chose to discontinue the medication.

CONCLUSIONS: Naltrexone may be a useful adjunctive treatment for CSB.

KEYWORDS: impulse control disorder, sexual disorder NOS, compulsive sexual behavior, sexual addiction, naltrexone, paraphilia

ANNALS OF CLINICAL PSYCHIATRY 2010;22(1):56–62

CORRESPONDENCE Nancy C. Raymond, MD Department of Psychiatry University of Minnesota Medical School F282/2AW 2450 Riverside Avenue Minneapolis, MN 55454 USA E-MAIL: raymo002@umn.edu
Annals of Clinical Psychiatry ©2010 American Academy of Clinical Psychiatrists

 
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