Nefazodone and the Treatment of Nonparaphilic Compulsive Sexual Behavior: A Retrospective Study

Background: Recent reports suggest that individuals with nonparaphilic compulsive sexual behavior can be treated pharmacologically with selective serotonin reuptake inhibitors (SSRIs) to control sexual obsessions and compulsions. However, these medications have produced sexual side effects that may limit long-term use, particularly as individuals strive to reestablish healthy sexual relationships. Nefazodone is an antidepressant that is not associated with the sexual side effects of other SSRIs. We examined retrospective data from our clinic to investigate whether nefazodone has utility in the treatment of nonparaphilic compulsive sexual behavior.

Method: Fourteen subjects who met DSM-IV criteria for sexual disorder NOS as well as criteria used by our research group for nonparaphilic compulsive sexual behavior and who had been treated with nefazodone were selected from patient charts at our clinic. The treating physician abstracted information from the charts regarding comorbid psychiatric conditions, medication, dosage, treatment response, and side effects.

Results: In this study, the mean dosage of nefazodone was 200 mg/day. Of the subjects who remained on long-term nefazodone therapy, 6 (55%) reported good control of sexual obsessions and compulsions, and 5 (45%) reported a remission of sexual obsessions and compulsions.

Conclusion: Results from this preliminary retrospective study suggest that nefazodone decreases the frequency of sexual obsessions and compulsions but does not produce the undesired sexual side effects caused by SSRI treatment.