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Review article
peer-reviewed

Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics



Abstract

Hypersexuality has been defined as abnormally increased sexual activity. Epidemiological and clinical studies have shown that this non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Hypersexual disorder is conceptualized as a non-paraphilic sexual desire disorder with impulsivity. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The nucleus accumbens, situated within the ventral striatum, mediates the reinforcing effects of drugs of abuse, such as cocaine, alcohol, nicotine, and food as well as music. Indeed, it is believed that this structure mandates behaviors elicited by incentive stimuli. These behaviors include natural rewards like feeding, drinking, sexual behavior, and exploratory locomotion. An essential rule of positive reinforcement is that motor responses will increase in magnitude and vigor if followed by a rewarding event. Here, we are hypothesizing that there is a common mechanism of action (MOA) for the powerful effects drugs, music, food, and sex have on human motivation. The human drive for the three necessary motivational behaviors "hunger, thirst, and sex" may all have common molecular genetic antecedents that, if impaired, lead to aberrant behaviors. We hypothesize that based on a plethora of scientific support hypersexual activity is indeed like drugs, food, and music that activate brain mesolimbic reward circuitry. Moreover, dopaminergic gene and possibly other candidate neurotransmitter-related gene polymorphisms affect both hedonic and anhedonic behavioral outcomes. There is little known about both the genetics and epigenetics of hypersexuality in the current literature. However, we anticipate that future studies based on assessments with clinical instruments combined with genotyping of sex addicts will provide evidence for specific clustering of sexual typologies with polymorphic associations. There have been some studies using electrophysiological techniques that do not support the view that hypersexuality is indeed similar to substance abuse and other behavioral addictions. The authors are also encouraging both clinical and academic scientists to embark on research using neuroimaging tools to examine natural dopaminergic agonistic agents targeting specific gene polymorphisms to "normalize" hypersexual behavior.



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Review article
peer-reviewed

Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics


Author Information

Kenneth Blum Corresponding Author

Department of Psychiatry, McKnight Brain Institute, University of Florida

Rajendra D. Badgaiyan

Department of Psychiatry, and Laboratory of Advanced Radiochemistry, University of Minnesota School of Medicine

Mark S. Gold

Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: The authors have declared the following conflicts of interest: Payment/services info: Dr. Blum is the co-recipient of a grant from the Life Extension Foundation, Ft. Lauderdale, FL, USA to Path Foundation, NYC, USA. Dr. Badgaiyan is supported by NIH 1R01NS07884. Financial relationships: Kenneth Blum declare(s) personal fees, a patent and royalties from Dominion Diagnostic LLC. License agreement for genetic testing. Kenneth Blum declare(s) non-financial support, royalties and stock/stock options from RDSS LLC. License agreement for Synaptamine. Kenneth Blum declare(s) personal fees, non-financial support and a patent from Victory Nutrition International, LLC. License agreement for Brain Reward. Kenneth Blum declare(s) non-financial support and a patent from Malibu Beach Recovery Center. Consultant. Kenneth Blum declare(s) personal fees, non-financial support and a patent from Rivermend Health. Member of the Scientific Advisory Board. Mark S. Gold declare(s) non-financial support and a patent from Rivermend Health. Chairman of the Scientific Advisory Board. Kenneth Blum declare(s) royalties from Impact Genomics . License agreement for Synaptagenx. Intellectual property info: US patent no. 6,132,724; 6,955,873 issued. US PATENT APPLICATION 11/250,355; PCT /US2009/048074; PROVISIONAL 62,08,173.

Acknowledgements

The authors appreciate the expert edits and artwork design of Margaret A. Madigan.


Review article
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Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics


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Review article
peer-reviewed

Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics

  • Author Information
    Kenneth Blum Corresponding Author

    Department of Psychiatry, McKnight Brain Institute, University of Florida

    Rajendra D. Badgaiyan

    Department of Psychiatry, and Laboratory of Advanced Radiochemistry, University of Minnesota School of Medicine

    Mark S. Gold

    Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: The authors have declared the following conflicts of interest: Payment/services info: Dr. Blum is the co-recipient of a grant from the Life Extension Foundation, Ft. Lauderdale, FL, USA to Path Foundation, NYC, USA. Dr. Badgaiyan is supported by NIH 1R01NS07884. Financial relationships: Kenneth Blum declare(s) personal fees, a patent and royalties from Dominion Diagnostic LLC. License agreement for genetic testing. Kenneth Blum declare(s) non-financial support, royalties and stock/stock options from RDSS LLC. License agreement for Synaptamine. Kenneth Blum declare(s) personal fees, non-financial support and a patent from Victory Nutrition International, LLC. License agreement for Brain Reward. Kenneth Blum declare(s) non-financial support and a patent from Malibu Beach Recovery Center. Consultant. Kenneth Blum declare(s) personal fees, non-financial support and a patent from Rivermend Health. Member of the Scientific Advisory Board. Mark S. Gold declare(s) non-financial support and a patent from Rivermend Health. Chairman of the Scientific Advisory Board. Kenneth Blum declare(s) royalties from Impact Genomics . License agreement for Synaptagenx. Intellectual property info: US patent no. 6,132,724; 6,955,873 issued. US PATENT APPLICATION 11/250,355; PCT /US2009/048074; PROVISIONAL 62,08,173.

    Acknowledgements

    The authors appreciate the expert edits and artwork design of Margaret A. Madigan.


    Article Information

    Published: October 12, 2015

    DOI

    10.7759/cureus.348

    Cite this article as:

    Blum K, Badgaiyan R D, Gold M S (October 12, 2015) Hypersexuality Addiction and Withdrawal: Phenomenology, Neurogenetics and Epigenetics. Cureus 7(10): e348. doi:10.7759/cureus.348

    Publication history

    Peer review began: August 21, 2015
    Peer review concluded: September 09, 2015
    Published: October 12, 2015

    Copyright

    © Copyright 2015
    Blum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Hypersexuality has been defined as abnormally increased sexual activity. Epidemiological and clinical studies have shown that this non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Hypersexual disorder is conceptualized as a non-paraphilic sexual desire disorder with impulsivity. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The nucleus accumbens, situated within the ventral striatum, mediates the reinforcing effects of drugs of abuse, such as cocaine, alcohol, nicotine, and food as well as music. Indeed, it is believed that this structure mandates behaviors elicited by incentive stimuli. These behaviors include natural rewards like feeding, drinking, sexual behavior, and exploratory locomotion. An essential rule of positive reinforcement is that motor responses will increase in magnitude and vigor if followed by a rewarding event. Here, we are hypothesizing that there is a common mechanism of action (MOA) for the powerful effects drugs, music, food, and sex have on human motivation. The human drive for the three necessary motivational behaviors "hunger, thirst, and sex" may all have common molecular genetic antecedents that, if impaired, lead to aberrant behaviors. We hypothesize that based on a plethora of scientific support hypersexual activity is indeed like drugs, food, and music that activate brain mesolimbic reward circuitry. Moreover, dopaminergic gene and possibly other candidate neurotransmitter-related gene polymorphisms affect both hedonic and anhedonic behavioral outcomes. There is little known about both the genetics and epigenetics of hypersexuality in the current literature. However, we anticipate that future studies based on assessments with clinical instruments combined with genotyping of sex addicts will provide evidence for specific clustering of sexual typologies with polymorphic associations. There have been some studies using electrophysiological techniques that do not support the view that hypersexuality is indeed similar to substance abuse and other behavioral addictions. The authors are also encouraging both clinical and academic scientists to embark on research using neuroimaging tools to examine natural dopaminergic agonistic agents targeting specific gene polymorphisms to "normalize" hypersexual behavior.



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Kenneth Blum

Department of Psychiatry, McKnight Brain Institute, University of Florida

For correspondence:
drd2gene@gmail.com

Rajendra D. Badgaiyan, M.D., Professor

Department of Psychiatry, and Laboratory of Advanced Radiochemistry, University of Minnesota School of Medicine

Mark S. Gold

Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA

Kenneth Blum

Department of Psychiatry, McKnight Brain Institute, University of Florida

For correspondence:
drd2gene@gmail.com

Rajendra D. Badgaiyan, M.D., Professor

Department of Psychiatry, and Laboratory of Advanced Radiochemistry, University of Minnesota School of Medicine

Mark S. Gold

Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA