Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options.

Gemma Mestre-Bach, Marc N Potenza

Journal: CNS drugs 2024;38(4):255-265

PMID: 38485889

Abstract

Compulsive sexual behavior disorder (CSBD) has recently been recognized as a psychiatric disorder. Pharmacological treatments for CSBD have received little study and thus have limited empirical support. The main objective of the present work is to review existing literature on the efficacy of different drugs on the symptomatology of CSBD, including the subtype of problematic pornography use (PPU). The main pharmacological approaches to treating CSBD have included opioid antagonists (naltrexone and nalmefene), selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, and sertraline), mood stabilizers (topiramate), tricyclic antidepressants (clomipramine), serotonin antagonist and reuptake inhibitors (nefazodone), and N-acetylcysteine. Since people with CSBD may experience different co-occurring disorders, these should be considered when choosing the best pharmacological treatment. Pharmacological therapy for CSBD/PPU has been suggested as an adjunct to psychological therapies, which, for the moment, have the most empirical evidence. However, to evaluate the efficacy of most of the drugs presented in this narrative review, data to date have only been available from case studies. Thus, empirical support is scant and generalizability of results is limited, highlighting the need for more research in this area.

© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Address: Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain.; Department of Psychiatry, Yale University School of Medicine, One Church Street, Rm 726, New Haven, CT, 06510, USA. [email protected].; Connecticut Mental Health Center, New Haven, CT, USA. [email protected].; Connecticut Council on Problem Gambling, Wethersfield, CT, USA. [email protected].; Wu Tsai Institute, Yale University, New Haven, CT, USA. [email protected].; Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA. [email protected].; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA. [email protected].

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