Administration of methylphenidate improves hypersexual behaviour in a 22-year-old woman with attention deficit hyperactivity disorder: a case report

Abstract

Background: Hypersexual behaviour is characterised by recurrent sexual fantasies, sexual urges and repeated sexual behaviours and is often associated with attention deficit hyperactivity disorder (ADHD). Although hypersexual behaviour is not an uncommon phenomenon, only few and controversial treatment options are known so far. To our best knowledge, this is the first report which describes the successful treatment of hypersexual behaviour with methylphenidate in an adult diagnosed with ADHD. Methods: We report the case of a 22-year-old woman diagnosed with ADHD accompanied by recurrent depressive episodes with pronounced hypersexual behaviour. At first admission in our day clinic, the patient reported core symptoms of sustained tension, pronounced impulsivity as well as an uncontrollable sexual urge. The latter was experienced as stressful and unpleasant. As we suspected the diagnosis of ADHD in adulthood, we started a pharmacotherapy with methylphenidate. After the intake, we initially observed a reduction of restlessness and an improvement of concentration which was stable until her discharge. In a follow-up after 15 weeks the patient additionally reported a reduction of her sexual impulses and a significant decrease of her sexual urge since the administration of methylphenidate. This improvement was substantiated by a significantly decreased score on the Hypersexual Behaviour Inventory scale. Conclusion: Administration of methylphenidate might be an alternative pharmacological approach for the treatment of patients suffering from uncontrollable sexual urges and hypersexual behaviour. However, further research is needed to assess the broader efficacy of methylphenidate in the treatment of hypersexual behaviour in patients with and without ADHD.