From the Guidelines
Selective serotonin reuptake inhibitors (SSRIs) are the primary medications used to treat hypersexual psychiatric patients, with daily dosing of paroxetine 10-40 mg, sertraline 50-200 mg, fluoxetine 20-40 mg, and citalopram 20-40 mg being effective in reducing sexual urges. When considering treatment for hypersexual psychiatric patients, it is essential to prioritize medications that can effectively manage symptoms while minimizing potential side effects. According to the most recent guidelines, SSRIs are the first-line treatment for premature ejaculation, which can be a symptom of hypersexuality 1. The use of SSRIs, such as paroxetine, sertraline, and fluoxetine, has been shown to delay ejaculation and reduce sexual urges, making them a suitable option for treating hypersexual psychiatric patients 1. Some key points to consider when prescribing SSRIs for hypersexual psychiatric patients include:
- Daily dosing is more effective than on-demand treatment in delaying ejaculation 1
- Paroxetine has been shown to exert the strongest ejaculation delay, increasing ejaculatory latency time (ELT) by a mean of 8.8-fold over baseline 1
- SSRIs should be avoided in men with a history of bipolar depression due to the risk of mania 1
- Patients should be advised to avoid sudden cessation or rapid dose reduction of daily dosed SSRIs to prevent SSRI withdrawal syndrome 1 It is crucial to weigh the potential benefits and risks of SSRIs in hypersexual psychiatric patients, particularly regarding the risk of suicidal ideation, and to closely monitor patients for any adverse effects 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Medications for Hypersexual Psychiatric Patients
- Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat hypersexual psychiatric patients, as they help manage uncontrollable impulses and urges by reducing excessive sexual behavior 2, 3, 4.
- Fluoxetine, a type of SSRI, has been successfully used to treat a patient with compulsive sexual behavior (CSB) disorder 2.
- Other SSRIs, such as fluvoxamine, sertraline, and paroxetine, have also been studied and compared in terms of their safety and side-effect profiles 5.
- Naltrexone could be another therapeutic option for treating sexual addiction 4.
- Antiandrogens, such as gonadotropin-releasing hormone (GNRH) agonists, have also been used to treat paraphilias and hypersexual disorders, although further study is needed 3.
Treatment Approaches
- Psychotherapy, particularly cognitive-behavioral therapy, is often used in association with pharmacotherapy to treat hypersexual psychiatric patients 3, 4.
- A comprehensive and efficient treatment approach must be proposed, taking into account the significant psychiatric and addictive comorbidities associated with hypersexual behavior 4.
- Treatment algorithms suggest beginning with less restrictive treatments, such as behavioral or verbal therapies, and moving to more restrictive alternatives, such as biological therapies, as needed 3.