https://orcid.org/0000-0003-2021-8253
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Abstract
Objectives
The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.
Methods
An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.
Results
Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.
Conclusions
An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
Disclosure statement
Daniel Turner, PhD, has no conflict of interest with respect to the content of this manuscript.
Prof. Briken was an advisor to the WHO with regard to the classification of sexual disorders in ICD-11. He is currently an associate editor for the Journal of Sexual Medicine. He currently receives funding from the European Union and the Federal Ministry of Education and Research, Germany.
Joshua B. Grubbs, Ph.D., has no conflict of interest with respect to this manuscript. Dr. Grubbs currently receives funding from the Kindbridge Research Institute, the International Centre for Responsible Gaming, the National Institute for Civil Discourse, and the Conru Foundation. Dr. Grubbs is currently an associate editor for Archives of Sexual Behaviour and a consulting editor for the American Psychological Association’s Psychology of Addictive Behaviours.
Leo Malandain has no conflict of interest with respect to the content of this manuscript. He receives funding from the region Ile de France (PHRC).
Dr. Gemma Mestre-Bach has no conflict of interest with respect to the content of this manuscript. Dr. Mestre-Bach has a postdoctoral grant from FUNCIVA.
Prof. Potenza has no conflict of interest with respect to the content of this manuscript. Prof. Potenza has consulted for and advised Game Day Data, Opiant Pharmaceuticals, Idorsia, BariaTek, the Addiction Policy Forum and AXA; has been involved in a patent application with Yale University and Novartis; has received research support from the Mohegan Sun Casino and the Connecticut Council on Problem Gambling; has participated in surveys, mailings or telephone consultations related to addictive disorders or other health topics; has consulted for or advised law offices and gambling entities on issues related to addictive disorders and behaviours; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.
Prof. Thibaut is Editor-in-chief of Dialogues in Clinical Neurosciences (the journal received a grant from La Conférence Hippocrate Servier until September of 2020). She receives funding from the French government (PHRC).