Pharmacology

Unfortunately, the usefulness of pharmacotherpay in the treatment of sexual aversion has not been adequately explored in the literature. Kaplan (2) describes the use of monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants for treating sexual aversion disorder, commenting on the well-established efficacy of these medications in the treatment of panic. Subsequently, of course, selective serotonin reuptake inhibitors (SSRIs) have also been demonstrated to be effective in treating panic and may, therefore, have a role in the treatment of sexual aversions. Importantly, anorgasmia is a potential side-effect of SSRIs, but patients will sometimes find it preferable to aversion.

In our case example, Sertraline was an important adjunct to Joyce's treatment. She reported that the medication helped decrease her distress as she engaged in the exposure process. She felt that her use of relaxation strategies to modulate anxiety was aided somewhat when the SSRI was added, and she attributed a general improvement in her mood to the medication as well.

In practice, as illustrated in this case, cognitive behavioral, psychodynamic, and pharmacotherapeutic strategies are often integrated very effectively as each approach serves to enhance and augment the others.

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