Serotonergic medications for sexual obsessions, sexual addictions, and paraphilias.
BACKGROUND
Paraphilias and related disorders have recently been thought of as sexual addictions. However, it has also been argued that these disorders are sexual compulsions. The question arises as to whether these disorders and obsessive compulsive disorder respond in the same way to pharmacotherapy.


METHODS
We retrospectively reviewed outcome in 13 patients who presented with sexual symptoms and were treated with serotonin reuptake blockers. Symptoms were divided into paraphilias, nonparaphilic sexual addictions, and sexual obsessions.


RESULTS
Paraphilias had the least improvement, while sexual obsessions had the best response to medication.


CONCLUSIONS
Paraphilias and related disorders may be less responsive than sexual obsessions or compulsions to serotonin reuptake blockers. Perhaps paraphilias and related disorders are on the impulsive rather than the compulsive end of the spectrum of obsessive compulsive disorders. Controlled trials are, however, necessary to replicate these preliminary findings.
Stein
D J
DJ
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York 10032.
Hollander
E
E
Anthony
D T
DT
Schneier
F R
FR
Fallon
B A
BA
Liebowitz
M R
MR
Klein
D F
DF
D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002997:Clomipramine / Q000627:therapeutic use; D005277:Fenfluramine / Q000627:therapeutic use; D005473:Fluoxetine / Q000627:therapeutic use; D016666:Fluvoxamine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use*; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D010262:Paraphilic Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012701:Serotonin / Q000502:physiology*
D014179:Neurotransmitter Uptake Inhibitors; D005473:Fluoxetine; D005277:Fenfluramine; D012701:Serotonin; D002997:Clomipramine; D016666:Fluvoxamine