Hypersexuality and pharmacological treatment options

Objectives
There are no standardised guidelines regard ing the pharmacotherapy of compulsive sexual beha viour. The paper aims to review the available literature concerning the treatment of excessive sexual activity dis orders. Specific mechanisms underlying hypersexuality and the consequent potential differences in its treatment were considered.

Literature review
The classification of sexual disorders related to excessive sexual activity is rather problematic. Both DSM-5 and ICD-11 lack in a homogenous classifi cation of this disorder. Currently, the safest and most beneficial drugs for patients with non-paraphilic dis orders seem to be SSRI medications. Drugs presenting an antiandrogenic action (LHRH) are not recommen ded due to their side effects, apart from cases proceeding with severe symptoms. Promising results were obtained in a trial with naltrexone; yet, the study did not fulfil methodological norms. Other medications used in the treatment of hypersexuality are of minor importance; however, they may be used especially when psychiatric comorbidities are present

Conclusions
The best effects in the treatment of com pulsive sexual behaviour are obtained with the combi nation of psychotherapy and SSRI drugs. Few method ologically correct studies have been performed. Most studies are carried out on small groups and fail to use methods which would enable to compare various thera peutic options. Research on the pharmacotherapy of non-paraphilic hypersexuality should be continued, especially regarding drugs which may act on the obsessi ve-compulsive mechanism.