Tolerability and efficacy of paroxetine and naltrexone for treatment of compulsive sexual behavior disorder

World Psychiatry | September 14, 2022


Studies focusing on pharmacotherapy of CSBD are limited, and the purpose of which is to prevent behavior leading to criminal offenses. Gonadotropin-releasing hormone antagonists are effective and have a rapid onset; however, the long-term side effects are significant.

In the current study, paroxetine and naltrexone, both of which had mild and transient side effects, were effective in reducing sexual impulsivity and improving the quality of life.

This was a 20-week double-blind, placebo-controlled randomized clinical trial involving 73 heterosexual, cisgender males (mean age = 35.7 years) attending an outpatient sexology clinic.

Of the study subjects, 24, 24, and 25 received paroxetine (20 mg/d), naltrexone (50 mg/d), or placebo, respectively. The Hypersexual Behavior Inventory, Brief Pornography Screen, and Sexual Addiction Screening Test were used to evaluate the response to treatment.

Patients treated with paroxetine or naltrexone reported a 30-day cessation of any compulsive sexual behavior as early as week 8 of the trial. Sexual binge activity was decreased by week 20 of the trial in the paroxetine and naltrexone groups. In addition, craving for sex and pornography consumption was decreased by week 20 in the paroxetine and naltrexone groups.

The efficacy of paroxetine was superior to naltrexone, but the difference was not statistically significant.