Hypersexuality and its response to citalopram in a patient with hypothalamic hamartoma and precocious puberty.

Hypersexuality has been defined as the subjective experience of loss of control over sexuality (Catalan and Singh, 1995). It is known to be associated with mood, impulse and compulsive disorder (Coleman and Kafka, 1991) and with biological factors such as brain injury involving septal nuclei (Gorman and Cummins, 1992) and dementia (Potocnik, 1992). Sexual addiction is synonymous with hypersexuality, which is defined as a condition in which some form of sexual behaviour is employed in a pattern that is characterized by two key factors : (1) recurrent failure to control the sexual behaviour and (2) continuation of the sexual behaviour despite significant harmful consequences (Goodman, 1998). Kafka (1991) defined non-paraphilic sexual addictions as culturally acceptable sexual interests and behaviours that increase in frequency or intensity so as to significantly interfere with the desired capacity for a sustained intimate sexual relationship. These behaviours may include compulsive masturbation, dependence on anonymous sexual outlets like pornography, or telephone sex, and repetitive promiscuity involving using people as sexual objects. Over recent times a lot of interest has been generated in understanding the physiological aspects and pharmacological management of hypersexuality/sexual addiction/compulsive sexual behaviour. Selective serotonin reuptake inhibitors (SSRIs) have been proposed as a treatment option following studies demonstrating their inhibitory effect on 5-HT2 receptors (Kafka, 1995). Here we report a case believed to be the first of its kind of a patient with hypothalamic hamartoma and hypersexuality who responded to citalopram.