EpistemisHypersexuality
Specialty: Psychiatry.
Why it occurs
- Manic or hypomanic episode of bipolar disorder
- Primary compulsive sexual behavior disorder
- Adverse effect of dopamine agonists (e.g., Pramipexole in Parkinson's)
- Frontotemporal dementia (loss of cortical social inhibition)
- Borderline or histrionic personality disorder
- Consumption of stimulants (methamphetamine, cocaine) or quimsex (chemsex)
Initial workup
Complete serological screening for sexually transmitted infections; assessment of impulsivity (Barratt scale); toxicological screening; Brain MRI to assess frontal lobe atrophy.
red flags
Deliberate exposure to situations of very high risk of physical aggression, contagion of serious STIs (HIV, syphilis), economic ruin due to consumption of sexual services, or legal problems derived from inappropriate behavior in public spaces.
Standard management
- Mood stabilizers such as Lithium Carbonate or Valproic Acid — if it is framed in bipolar disorder
- Second generation antipsychotics such as Risperidone — for the control of impulsivity and behavioral disinhibition
- Medroxyprogesterone or Cyproterone Acetate — potent antiandrogens, used in extreme cases of persistent hypersexuality with serious legal or criminal consequences
- SSRIs such as Fluoxetine (can be useful to mitigate the obsessive-compulsive sexual urge).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4