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Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options

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Abstract

Compulsive sexual behavior disorder (CSBD) has recently been recognized as a psychiatric disorder. Pharmacological treatments for CSBD have received little study and thus have limited empirical support. The main objective of the present work is to review existing literature on the efficacy of different drugs on the symptomatology of CSBD, including the subtype of problematic pornography use (PPU). The main pharmacological approaches to treating CSBD have included opioid antagonists (naltrexone and nalmefene), selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, and sertraline), mood stabilizers (topiramate), tricyclic antidepressants (clomipramine), serotonin antagonist and reuptake inhibitors (nefazodone), and N-acetylcysteine. Since people with CSBD may experience different co-occurring disorders, these should be considered when choosing the best pharmacological treatment. Pharmacological therapy for CSBD/PPU has been suggested as an adjunct to psychological therapies, which, for the moment, have the most empirical evidence. However, to evaluate the efficacy of most of the drugs presented in this narrative review, data to date have only been available from case studies. Thus, empirical support is scant and generalizability of results is limited, highlighting the need for more research in this area.

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Authors and Affiliations

  1. Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain

    Gemma Mestre-Bach

  2. Department of Psychiatry, Yale University School of Medicine, One Church Street, Rm 726, New Haven, CT, 06510, USA

    Marc N. Potenza

  3. Connecticut Mental Health Center, New Haven, CT, USA

    Marc N. Potenza

  4. Connecticut Council on Problem Gambling, Wethersfield, CT, USA

    Marc N. Potenza

  5. Wu Tsai Institute, Yale University, New Haven, CT, USA

    Marc N. Potenza

  6. Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    Marc N. Potenza

  7. Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA

    Marc N. Potenza

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Correspondence to Marc N. Potenza.

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This work was supported by the ITEI B23-010 project (Universidad Internacional de La Rioja).

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Neither of the authors have any conflicts of interest. Dr. Potenza discloses that he has consulted for and advised Game Day Data, Addiction Policy Forum, AXA, Idorsia, Baria-Tek, and Opiant Therapeutics; been involved in a patent application with Yale University and Novartis; received research support from the Mohegan Sun Casino, Children and Screens and the Connecticut Council on Problem Gambling; consulted for or advised legal and gambling entities on issues related to impulse control, internet use and addictive behaviors; provided clinical care related to impulse-control and addictive behaviors; performed grant reviews; edited journals/journal sections; given academic lectures in grand rounds, CME events, and other clinical/scientific venues; and generated books or chapters for publishers of mental health texts.

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Mestre-Bach, G., Potenza, M.N. Current Understanding of Compulsive Sexual Behavior Disorder and Co-occurring Conditions: What Clinicians Should Know about Pharmacological Options. CNS Drugs 38, 255–265 (2024). https://doi.org/10.1007/s40263-024-01075-2

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