Naltrexone in Compulsive Sexual Behavior Disorder: A Feasibility Study of Twenty Men (2020)

Savard, Josephine, Katarina Görts Öberg, Andreas Chatzittofis, Cecilia Dhejne, Stefan Arver, and Jussi Jokinen.

The Journal of Sexual Medicine (2020).

Abstract

Background

Compulsive sexual behavior disorder (CSBD) is a common disorder affecting different areas of life, although studies focusing on pharmacological treatment are sparse.

Aim

To investigate whether the opioid receptor antagonist naltrexone is feasible and tolerable and can provide symptom reduction in CSBD.

Methods

Twenty men aged 27–60 years (mean = 38.8 years, standard deviation = 10.3) with CSBD seeking treatment in an outpatient nonforensic clinic received four weeks of naltrexone 25–50 mg. Measurements were made before, during, and four weeks after treatment.

Outcomes

The self-assessment Hypersexual Disorder: Current Assessment Scale (HD: CAS) score was the primary outcome measure, and secondary outcomes were the Hypersexual Behavior Inventory (HBI) score, reported adverse effects, adherence to treatment, and dropouts.

Results

There was significant decrease on both HD: CAS and HBI scores during treatment with naltrexone. Even though some of the effects remained after treatment, the increased scores on HD: CAS indicated worsening of CSBD symptoms. The most reported side effects were fatigue (55%), nausea (30%), vertigo (30%), and abdominal pain (30%). However, there were no serious adverse effects leading to discontinuation of naltrexone.

Clinical Implications

Despite side effects being common, naltrexone seems to be feasible in the treatment of CSBD.

Strengths & Limitations

Being the first nonforensic prospective trial on naltrexone in CSBD, this study provides novel insights on a pharmacological intervention. However, owing to the small sample size and the lack of a control group, conclusions of effectiveness should be interpreted with caution.

Conclusion

Naltrexone is feasible and tolerable and may reduce symptoms of CSBD; nevertheless, future studies should ensure a randomized controlled procedure to evaluate possible effectiveness.

Key Words – Compulsive sexual behavior disorder, Naltrexone, Hypersexual disorder, Sexual addiction