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

Ann Clin Psychiatry. 2010 Feb;22(1):56-62.

Abstract

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.

MeSH terms

  • Adult
  • Comorbidity
  • Compulsive Behavior / drug therapy*
  • Compulsive Behavior / epidemiology
  • Compulsive Behavior / psychology
  • Disruptive, Impulse Control, and Conduct Disorders / drug therapy*
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology
  • Disruptive, Impulse Control, and Conduct Disorders / psychology
  • Humans
  • Liver Function Tests / methods
  • Liver Function Tests / statistics & numerical data
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Middle Aged
  • Minnesota
  • Naltrexone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Retrospective Studies
  • Sexual Behavior / drug effects*
  • Sexual Behavior / psychology
  • Sexual Dysfunctions, Psychological / drug therapy*
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / psychology
  • Treatment Outcome

Substances

  • Narcotic Antagonists
  • Naltrexone