Sex addiction: are there any effective treatment?

During the last few years a new addiction has been on the rise. This is the addiction to sex. A sexual addict is a person with an intense obsession about sex. Sex dominates these addicts’ life and all their acts are orientated towards having sex in many different ways. Some behaviors related to this disorder are compulsive masturbation, multiple and extra-marital affairs, unsafe sex, use of pornography, phone and/or computer sex, and when the disorder progresses in a uncontrolled way, the addict may be involved in illegal activities such as obscene phone calls, rapes, exhibitionism, etc. This conduct has several consequences on the addict’s integrity, leading to feelings of guilt, economic, health, social and emotional problems.

At the moment, no specific drugs exist for this disorder; sometimes psychiatric drugs for obsessive-compulsive disorder such as Prozac, anafranil and selective serotonin reuptake inhibitors (SRI) are used in sex addiction to treat the psychological aspects commonly associated, such as depression. When these addicts have sex, they get the highest reward - their brains produce dopamine, serotonin and oxytocin, and these chemicals produce a feeling of pleasure. The low level of these chemicals is associated with an increase of impulsive and aggressive behavior.

On the other hand, when compulsive-obsessive behavior patients are treated with SRIs, they experiment a decrease in the frequency and intensity of impulsive behaviors. Therefore, the sex addiction patients in many cases are treated with these drugs and in many cases important benefits have been reported, such as the relief of anxiety and obsessive thinking. However, SRIs also present sexual side effects. These drugs delay the orgasm and reduce the libido, and these effects are the reasons for the negative results shown for these treatments in many cases. Instead of reducing the preoccupation of these patients for sex, the medication increases the frustration and makes the situation worse. This produces negative results in sex addiction treatments and the conventional solutions are the use of SRIs with fewer risks of these effects such as escitalopram, or the combined use of a SRI and nafazodone or bupropion in order to reduce the sexual side effects of the SRIs.

Due to the lack of efficacy of the current treatments for sex addiction, new pharmacotherapies are being developed. Considering Professor S. W. Kim’s suggestion that neurological mechanisms underlying the impulsive behaviors may be the same as the mechanisms involved in drugs cravings, studies using naltrexone had been carried out at the University of Minnesota. These studies displayed a significant reduction in sexual behaviors of the patients treated with this opiate antagonist, however, high dosages of naltrexone or its combination with pain medication such as ibuprofen and aspirin can lead to liver problems.

Other potential drugs used in antidepressant therapies, narcolepsy, maniac-depressive treatments and antipsychotic drugs, such as bupropion, modafanil, olanzapine, rispiridone, etc. can be used or added to sex addiction treatment. The lack of a specific pharmacotherapy for sex addiction makes the use of behavior therapies very important. The control of the addictive behavior is crucial in the treatment. In this sense, the patients must admit their problem and follow expert instructions, and attend the counseling, family, marital and educational therapies in order to have success with the treatment.

Finally, the establishment of a consensus about the criteria to develop an effective diagnostic is required, and more studies are needed in order to develop specific drugs for sex addiction and increase their effectiveness, as well as the corresponding therapy. We shouldn’t wait until the problem becomes a major problem, as in the case of cocaine.

Written by Dr. Daniel Jimenez for The All Results Journals.