Nalmefene in the Treatment of Internet Pornography Addiction – A Case Report and Review of Literature

Abstract

The mu-opioid antagonist nalmefene (18 mg per day) was administered in the treatment of a heterosexual male with internet pornography addiction. The patient had no other co-addictions or psychiatric comorbidities, allowing a direct measurement for the effectiveness of nalmefene on internet pornography addiction. Over a period of 72 weeks and an assessment frequency between 1 and 18 weeks, self-monitoring assessments of craving and pornography consumption were collected on different craving and obsessive-compulsive scales. Results indicate that nalmefene impressively decreased addictive symptoms. Importantly, the patient-induced discontinuation of nalmefene led to an immediate increase of craving scores and addictive behavior, which dropped again after restarting the medication. The patient has been in complete remission of symptoms for over a year under our supervision, and for further 2 years after that according to his account. Therefore, nalmefene seems to be a useful adjunction for patients with internet pornography addiction.

Aligning the “Manifesto for a European Research Network into Problematic Usage of the Internet” with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography

“…Early work focused on possible similarities to obsessive compulsive disorder and suggested trying drugs known as selective serotonin re-uptake inhibitors (SSRIs). Recent case reports have been published for Paroxetine [71], Nalmefene [49] and Aripiprazole [72], with mixed results.…”

“…Most research published to date has focused on teens or university students, though around half of all pornography viewers are older [8]. This makes case studies or more specific work on older people very rare [48,49]. It would also allow us to look at the potentially very different trajectories of younger populations who began with access to unlimited, free streaming videos in or around 2008, and older users who may have transitioned through several successive modes of access to pornography such as magazines and DVDs, to Internet use.…”

Opioid Overdose: Limitations in Naloxone Reversal of Respiratory Depression and Prevention of Cardiac Arrest

“…48 The oral formulation is still available for treatment of alcohol dependence and other forms of addiction. 49,50 Nalmefene remains an attractive naloxone alternative as it has high affinity for the µ-opioid receptor, is 10 times more potent than naloxone, and has an 8- to 10-fold longer half-life (8 to 11 h) than naloxone, reducing the likelihood of renarcotization from even long-acting opioids. 47,51 Recently, intranasal nalmefene was developed and studied for treatment of an opioid overdose.…”