Clin Drug Invest 2007; 27 (3): 219-223 CASE REPORT 1173-2563/07/0003-0219/$44.95/0 © 2007 Adis Data Information BV. All rights reserved. Treatment of Compulsive Sexual Behaviour with Clomipramine and Valproic Acid Murat Gulsun, 1 Zeynep Gulcat 2 and Hamdullah Aydin 2 1 Isparta Military Hospital, Isparta Asker Hastanesi Psikiyatri Servisi, Egridir Yolu, Isparta, Turkey 2 Gata, Gulhane Military Medical Faculty, Psychiatry AD, Gulhane Tip Fak ¨ ultesi Psikiyatri AD, Etlik Ankara, Turkey The concepts of compulsive sexual behaviour or sexual addiction and treat- Abstract ment of the disorder have been argued over by many investigators. From a scientific point of view, both concepts are still not well established in psychiatric nomenclature. On the other hand, authors point out that compulsive sexual behaviour, obsessive-compulsive disorder and substance addiction show similari- ties in symptomatology and response to treatment. In this article, the case of a 21-year-old female exhibiting compulsive sexual behaviour since childhood who was treated with a combination of clomipramine and valproic acid is presented and discussed in the light of the relevant literature. Both the existence and nature of compulsive sex- The psychoanalytic literature on female hyper- sexuality emphasises the obsessional aspect of the ual behaviour or sexual addiction have been argued disorder. Previously, Fenichel explained exaggerat- over by many investigators, and both concepts re- ed sexual activity as an ‘obsession’; i.e. an unsuc- main controversial with respect to psychiatric classi- cessful attempt to use the genital apparatus for dis- fications of disease. Individuals with compulsive charging some non-genital need. [6] He also suggest- sexual behaviour are often unable to control their ed that hypersexuality in women may be a sexual behaviour, may act out impulsively, and/or revengeful behaviour related to penis envy with are often plagued by intrusive obsessive thoughts resultant aggression toward men, who are held re- and driven behaviours. [1] Barth and Kinder argued sponsible for the deprivation. Allen claimed that the for the use of impulse control disorder as a descrip- hypersexual woman was to some extent homosexual tion of this condition, [2] although compulsivity and and thus behaves in an active rather than a passive addiction labels are consistent with Diagnostic and way. [7] However, such concepts are not widely ac- Statistical Manual of Mental Disorders (DSM) crite- cepted. ria. [3] Bancroft and Vukadinovic explained sexual A tendency to experience increased sexual inter- disorders as dysregulations of excitatory and inhibi- est in states of depression or anxiety has been found tory mechanisms. [4] In the past, many labels have to be strongly characteristic of the sex addict been applied to sexual addiction, including nympho- group. [4] Dissociative experiences have been de- mania, satyriasis and hypersexuality. [5] scribed by 45% of sex addicts and may have some