title: Paroxetine Treatment of Problematic Pornography Use: A Case Series.
abstract: Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive-compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.
authors.affiliation: 1 Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego , San Diego, CA, USA.|2 Institute of Psychology, Polish Academy of Sciences , Warsaw, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Gola
authors.affiliation: 3 Department of Psychiatry, Child Study Center and CASAColumbia, Yale School of Medicine , New Haven, CT, USA.|4 Department of Neurobiology, Child Study Center and CASAColumbia, Yale School of Medicine , New Haven, CT, USA.|5 Connecticut Mental Health Center , New Haven, CT, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use; D016739:Behavior, Addictive / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004882:Erotica; D020010:Heterosexuality; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014151:Anti-Anxiety Agents; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors
keywords: case series; paroxetine; pharmacotherapy; problematic pornography use