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A Double-Blind Study of Citalopram Versus Placebo in the Treatment of Compulsive Sexual Behaviors in Gay and Bisexual Men

J Clin Psychiatry 2006;67(12):1968-1973

Objective: Compulsive sexual behavior (CSB) is a condition characterized by loss of control over sexual behavior and repeated negative consequences, including unsafe sex. Selective serotonin reuptake inhibitors have been found to reduce CSB symptomatology in open-label trials. The objective of this study was to conduct a preliminary double-blind, placebo-controlled evaluation of the efficacy, acceptability, and tolerability of citalopram in the treatment of CSB.

Method: Twenty-eight men who have sex with men who met the threshold for CSB on the basis of existing validated measures participated in a 12-week, double-blind trial of citalopram 20 to 60 mg/day to evaluate its effects on CSB symptoms. The primary efficacy measure was the Yale-Brown Obsessive Compulsive Scale-Compulsive Sexual Behavior. The study was conducted from June 2002 to April 2004.

Results: Significant treatment effects were obtained for sexual desire/drive (p < .05) and frequency of masturbation (p < .01) and pornography use (p < .05). Both groups reduced sexual risk, but did not differ significantly.

Conclusions: This study provides partial support for the effectiveness of citalopram for reducing symptoms of CSB in this population. Larger-scale trials are recommended to determine the public health benefits of this treatment.