Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden; Anova, Karolinska University Hospital, Stockholm, Sweden.
Anova, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
J Sex Med. 2020 Aug;17(8):1544-1552. doi: 10.1016/j.jsxm.2020.04.318. Epub 2020 Jun 10.
Compulsive sexual behavior disorder (CSBD) is a common disorder affecting different areas of life, although studies focusing on pharmacological treatment are sparse.
To investigate whether the opioid receptor antagonist naltrexone is feasible and tolerable and can provide symptom reduction in CSBD.
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.
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.
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.
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.
Naltrexone is feasible and tolerable and may reduce symptoms of CSBD; nevertheless, future studies should ensure a randomized controlled procedure to evaluate possible effectiveness. Savard J, Öberg KG, Chatzittofis A, et al. Naltrexone in Compulsive Sexual Behavior Disorder: A Feasibility Study of Twenty Men. J Sex Med 2020;17:1544-1552.
强迫性性行为障碍（CSBD）是一种常见的影响生活各个方面的疾病，尽管针对药物治疗的研究很少。
研究阿片受体拮抗剂纳曲酮是否可行且耐受，并能减轻 CSBD 的症状。
20 名年龄在 27-60 岁（平均 38.8 岁，标准差 10.3）的 CSBD 男性患者在非法医门诊接受纳曲酮 25-50mg 四周治疗。在治疗前、治疗期间和治疗后四周进行测量。
自我评估的性瘾症：当前评估量表（HD：CAS）评分是主要的测量结果，次要结果是性瘾行为量表（HBI）评分、报告的不良反应、治疗依从性和脱落率。
纳曲酮治疗期间，HD：CAS 和 HBI 评分均显著下降。尽管治疗后仍有一些效果，但 HD：CAS 评分的增加表明 CSBD 症状恶化。最常见的不良反应是疲劳（55%）、恶心（30%）、眩晕（30%）和腹痛（30%）。然而，没有严重的不良反应导致纳曲酮停药。
尽管不良反应很常见，但纳曲酮似乎在 CSBD 的治疗中是可行的。
作为 CSBD 中纳曲酮的第一个非法医前瞻性试验，本研究提供了药物干预的新见解。然而，由于样本量小且缺乏对照组，有效性的结论应谨慎解释。
纳曲酮是可行且耐受的，可能减轻 CSBD 的症状；然而，未来的研究应确保采用随机对照程序来评估可能的有效性。Savard J、Öberg KG、Chatzittofis A 等人。纳曲酮治疗强迫性性行为障碍：20 名男性的可行性研究。性医学杂志 2020；17:1544-1552。
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