Compulsive Voyeurism and Exhibitionism: A Clinical Response to Paroxetine

Compulsive Voyeurism and Exhibitionism: A Clinical Response to Paroxetine
Journal article by Ahmed Abouesh, Anita Clayton; Archives of Sexual Behavior, Vol. 28, 1999

Journal Article Excerpt


Compulsive voyeurism and exhibitionism: a clinical response to paroxetine.

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by Ahmed Abouesh , Anita Clayton


INTRODUCTION

There has been an increased interest in the obsessive and compulsive nature of paraphilias and whether they lie within the obsessive-compulsive disorder (OCD) spectrum. The clinical response observed in patients with sexual paraphilias to selective serotonin reuptake inhibitors (SSRIs) has added to the hypothesis that sexual paraphilias could be a component of the OCD spectrum (Greenburg et al., 1996; Kafka, 1994).

Redefining sexual paraphilias as a component of the obsessive-compulsive spectrum might encourage the further use of SSRIs by the average psychiatrist, who might find it less threatening than antiandrogens. This would result in a much larger role being played in the treatment of paraphilias. (Bradford, 1995). Two patients are presented: Patient A is a voyeurist and is divorced; Patient B is an exhibitionist and is married. Both patients had some college education by the time they presented and were working. Neither had any medical or neurological problems. They presented with recurrent and persistent thoughts and impulses to act in a voyeuristic and exhibitionistic fashion, respectively. These thoughts were sexually exciting, but were followed by a deep sense of shame and guilt. Both patients were successfully treated with paroxetine, and showed a decrease in the intensity and frequency of these thoughts as well as improved impulse control.

Fluoxetine (Greenburg et al., 1996; Kafka and Prentky, 1992; Perilstein et al., 1991), sertraline (Greenburg et al., 1996; Kafka, 1994), fluoxamine (Greenburg et al., 1996), and clomipramine (Clayton, 1993) have been used to treat sexual paraphilia...


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