A difficult case of satyriasis in an adolescent responding ultimately to a combination of paliperidone palmitate and naltrexone

A case of excessive sexual drive or satyriasis

“…Naguy et al, categorises satyriasis into five subsets to aid treatment decisions (5). These categories are impulsive, compulsive, addictive, emotional dysregulation, and executive dysfunction types (5).…”

“…The impulsive subtype has been reported to respond to medications that block the limbic system (potent dopamine D2 receptor blockers such as risperidone) or to medication that enhances the prefrontal control such as stimulants while the compulsive subtype may respond to selective serotonin reuptake inhibitors (SSRIs) or clomipramine (5,9). Naltrexone can be considered in the addictive subtype and the emotional dysregulation subtype may respond to anticonvulsant mood stabilizers (e.g., valproate or topiramate) or beta-adrenergic blockers (e.g., propranolol) (5,10). The executive dysfunction subtype is associated with a lack of social decorum and poor insight and when in extreme, hormonal therapy had been suggested (5).…”

“…Naltrexone can be considered in the addictive subtype and the emotional dysregulation subtype may respond to anticonvulsant mood stabilizers (e.g., valproate or topiramate) or beta-adrenergic blockers (e.g., propranolol) (5,10). The executive dysfunction subtype is associated with a lack of social decorum and poor insight and when in extreme, hormonal therapy had been suggested (5).…”

“…Several case reports of satyriasis are available from other countries, however, there is a scarcity of such reports from Sri Lanka (4)(5)(6).…”