Sarangi Ashish, Jones Hannah, Bangash Fariha, Gude Jayasudha
Psychiatry, Baylor College of Medicine, Houston, USA.
Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA.
Cureus. 2021 Oct 3;13(10):e18463. doi: 10.7759/cureus.18463. eCollection 2021 Oct.
Sexual disinhibition is uncommon but challenging symptom to address in elderly patients with neurocognitive disorders. Due to the lack of large-scale studies, there is no gold standard treatment for sexual disinhibition, and treatment is largely left up to the discretion of the provider based on the severity and onset of the patient's symptoms. A review was conducted to investigate the non-pharmacological and pharmacological interventions for treating this condition. Articles that discussed treatments were screened for the type of treatment and possible side effects of medication if applicable. Thorough patient history should be taken prior to starting any drug therapy to rule out possible behavioral changes due to an existing medication side effect, delirium, or past mental or sexual health history. Non-pharmacological treatment has been generally recommended as first-line therapy over pharmacological treatment. Distraction/diversion of the patient when inappropriate sexual behaviors occur was the most common non-pharmacological intervention. Antidepressants were generally recommended as the first line of pharmacological treatment after attempting all possible non-pharmacological interventions. Several other categories of interventions are discussed as well in addition to the ethical implications of treating a patient for this condition.
性抑制解除在患有神经认知障碍的老年患者中并不常见，但却是一个具有挑战性的症状。由于缺乏大规模研究，对于性抑制解除没有金标准治疗方法，治疗很大程度上由医疗服务提供者根据患者症状的严重程度和发作情况自行决定。进行了一项综述以研究治疗这种情况的非药物和药物干预措施。筛选了讨论治疗方法的文章，以确定治疗类型以及适用时药物可能的副作用。在开始任何药物治疗之前，应全面了解患者病史，以排除由于现有药物副作用、谵妄或过去的精神或性健康史导致的可能行为变化。一般推荐非药物治疗作为比药物治疗更优先的一线治疗方法。当出现不适当性行为时转移/分散患者注意力是最常见的非药物干预措施。在尝试了所有可能的非药物干预措施后，一般推荐使用抗抑郁药作为一线药物治疗。除了治疗这种情况的伦理问题外，还讨论了其他几类干预措施。
