Augmentation with naltrexone to treat compulsive sexual behavior: a case series.
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.
Raymond
Nancy C
NC
Department of Psychiatry, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55454, USA. raymo002@umn.edu
Grant
Jon E
JE
Coleman
Eli
E
D000328:Adult; D015897:Comorbidity; D003192:Compulsive Behavior / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008111:Liver Function Tests / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D008910:Minnesota; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000187:drug effects* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D009271:Naltrexone