Hypersexuality and pharmacological treatment options

Abstract

Objectives. There are no standardised guidelines regarding the pharmacotherapy of compulsive sexual behaviour. The paper aims to review the available literature concerning the treatment of excessive sexual activity disorders. Specific mechanisms underlying hypersexuality and the consequent potential differences in its treatment were considered. Literature review. The classification of sexual disorders related to excessive sexual activity is rather problematic. Both DSM-5 and ICD-11 lack in a homogenous classification of this disorder. Currently, the safest and most beneficial drugs for patients with non-paraphilic disorders seem to be SSRI medications. Drugs presenting an antiandrogenic action (LHRH) are not recommended due to their side effects, apart from cases proceeding with severe symptoms. Promising results were obtained in a trial with naltrexone; yet, the study did not fulfil methodological norms. Other medications used in the treatment of hypersexuality are of minor importance; however, they may be used especially when psychiatric comorbidities are present. Conclusions. The best effects in the treatment of compulsive sexual behaviour are obtained with the combination of psychotherapy and SSRI drugs. Few methodologically correct studies have been performed. Most studies are carried out on small groups and fail to use methods which would enable to compare various therapeutic options. Research on the pharmacotherapy of non-paraphilic hypersexuality should be continued, especially regarding drugs which may act on the obsessive-compulsive mechanism.