How can I manage depression and sex obsession?

Question

Hello doctor,

A few years back I was diagnosed with depression and body dysmorphic disorder. Doctors prescribed me Fluoxetine 60 mg and afterward, Oxcarbazepine 300 mg or mood stabilizing medicines and my symptoms have settled down to 80 to 90 % better. But for some time I have developed an obsession with having sex with different partners each time. I think of girls and sex all the time. I stare at every beautiful girl and think of having sex with her. I am married now and these unwanted thoughts make me feel so guilty. I think all day about this and I cannot focus on other things. I kept finding different prostitutes to fulfill my desires and fantasies and after every encounter, I felt guilty and wanted to stop all this. I cannot share this with my wife. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your problem.

You have depression, and now your main symptoms are intrusive thoughts regarding sex and compulsive behavior related to sex. This results in guilt, which is probably deteriorating depression. The thoughts are most likely related to anxiety or part of OCD (obsessive-compulsive disorder). Though a more detailed evaluation is needed. Since these things could affect your marital life, this should be stopped.

Behavioral therapy and medicines can be used. Medicines like Fluoxetine (antidepressant) or Paroxetine (selective serotonin-reuptake inhibitors) can be tried. The drugs will help to reduce unwanted thoughts and will make your mood better. You can try these drugs to get out of negative thoughts. I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

In my opinion, there is no benefit in increasing the dose of Fluoxetine. We can think of Clonil or Clomipramine (antidepressant) in the present situation. Clomipramine in doses of 50 to 75 mg can help to reduce obsessive thoughts and compulsive sexual behavior.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Yes, other medicines like low-dose second-generation antipsychotic drugs can be used. You can talk with your doctor about Aripiprazole (antipsychotic). The drug will supplement the actions of Fluoxetine. Even Amisulpride (dopamine receptor antagonist) can be used. The drug will help to reduce unwanted thoughts and will improve your functioning. I hope you find this helpful.

Thank you.

Answer 4

Hello,

Welcome back to iclniq.com.

No, the disease does not follow a direct genetic inheritance. You will not transmit the problem to your baby.

I hope this helps.

Thank you.

Answer 5

Hello,

Welcome back to icliniq.com.

Thanks and take care.

Answer 6

Hello,

Welcome back to icliniq.com.

Fluoxetine is known to increase the Ejaculation time. The drug does not increase sexual obsession but in fact, will reduce it. So you can remain relaxed. Also, Carbamazepine is very safe. The drug is even used to stabilize the mood. I hope this will help you.

Thank you.