Naltrexone appears to be “feasible and tolerable” for the treatment of compulsive sexual behavior disorder (CSBD), according to new research in the Journal of Sexual Medicine.
Additional research is still needed, but a pilot study involving 20 men has shown encouraging results.
CSBD has been classified by the World Health Organization as an impulsive control disorder. Individuals with CSBD have strong, repetitive sexual urges that are difficult to control. Sexual behaviors start to interfere with their daily living, work, relationships, and personal care, causing great distress.
Experts estimate that 3% to 6% of the population has CSBD, but the rate could be higher.
Naltrexone is an opioid receptor agonist used to treat alcohol dependence. It has also been studied in the contexts of behavioral addictions like pathological gambling and kleptomania.
The current study included 20 Swedish men between the ages of 18 and 65 (average age 39). All of the men were interviewed by a psychiatrist and psychologist. (Note: The study was open to women, but no women volunteered.)
Participants also completed the Hypersexual Disorder: Current Assessment Scale (HD:CAS), which evaluates symptom severity over the prior two weeks. The Hypersexual Behavior Inventory (HBI) was also used.
Other assessment tools focused on compulsivity, hypersexuality, sexual orientation, depression, anxiety, alcohol use, and drug use.
The men were given 28 tablets containing 50 mg of naltrexone. They took half that dose at first, but if the drug was well tolerated after three to five days, the dose was increased to 50 mg.
The treatment period lasted four weeks, with progress being monitored during that time and for four additional weeks afterward.
About 70% of the men identified as heterosexual. Their most common problematic sexual behaviors were masturbation and pornography use. Eleven participants had a comorbid psychiatric diagnosis, with anxiety, attention deficit hyperactivity disorder (ADHD), and adjustment disorder being the most common.
All of the men adhered to the study protocol. Their liver function remained normal throughout and there were no serious adverse events. However, over half the men reported fatigue, and almost a third experienced nausea, vertigo, or abdominal pain. None of the men left the study due to side effects.
HD:CAS and HBI scores decreased, indicating improvement in CSBD symptoms. However, after treatment finished, symptoms tended to worsen.
The authors concluded that naltrexone is feasible for the treatment of CSBD. However, they called for several areas of further research. The small sample size and lack of a control group were limitations, they explained. They recommended that future researchers conduct a placebo-controlled trial with longer treatment and follow-up periods. Women should also be included, they said.
Resources
The Journal of Sexual Medicine
Savard, Josephine, MD, et al.
“Naltrexone in Compulsive Sexual Behavior Disorder: A Feasibility Study of Twenty Men”
(Full-text. Published: June 9, 2020)
https://www.jsm.jsexmed.org/article/S1743-6095(20)30535-X/fulltext