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

Milton L. Wainberg, M.D.; Frederick Muench, Ph.D.; Jon Morgenstern, Ph.D.; Eric Hollander, M.D.; Thomas W. Irwin, Ph.D.; Jeffrey T. Parsons, Ph.D.; Andrea Allen, Ph.D.; and Ann O'Leary, Ph.D.  

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.

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

Received Dec. 22, 2005; accepted May 16, 2006. From Columbia University, New York, N.Y. (Dr. Wainberg); Mount Sinai School of Medicine, New York, N.Y. (Drs. Muench, Morgenstern, Hollander, Irwin, and Allen); Hunter College and the Graduate Center of the City University of New York, New York, N.Y. (Dr. Parsons); and the Centers for Disease Control and Prevention, Atlanta, Ga. (Dr. O'Leary).

This study was conducted at the Department of Psychiatry of the Mount Sinai School of Medicine, New York, N.Y., and the Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), New York, N.Y.

Supported by a grant from the Centers for Disease Control and Prevention (U62 CCU217852) and the National Institute of Mental Health through an Inter-Agency Agreement.

Dr. Hollander has been a consultant for Forest. The other authors report no additional financial or other relationship relevant to the subject of this article.

Acknowledgments are listed at the end of the article.

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Corresponding author and reprints: Milton L. Wainberg, M.D., New York State Psychiatric Institute, 1051 Riverside Dr., Unit 112, New York, NY 10032 (e-mail: mlw35@columbia.edu).