Huntington's disease can manifest with neuropsychiatric and behavioural symptoms, including changes in sexual behaviour. While decreased libido is the most common sexual symptom, a subset of patients present with hypersexuality or disinhibited sexual behaviour — and when this rises to the level of causing social discomfort or involving violence, it becomes a distinct and urgent clinical concern.
This protocol addresses the specific situation in which a patient with Huntington's disease exhibits hypersexuality or disinhibited sexual behaviour that causes significant social discomfort or involves violent conduct. Although rarer than decreased libido, this presentation can cause severe problems in relationships and social functioning.
When pharmacological management of this presentation does not achieve adequate control, specialist-guided escalation involving a hormonal intervention class may be the next step — the full protocol details the specific approach and referral pathway.
DOI: 10.3389/fneur.2019.00710
Decreased libido is the most common symptom while hypersexuality or disinhibited behavior are rarer, but can cause significant problems in relationships.
If hypersexuality involves social discomfort or violence, the proposed first-line treatment is a neuroleptic (Grade C) and/or a SSRI.
If the treatment for hypersexuality with neuroleptics and/or SSRI is not successful, the addition of or substitution for an anti-androgen may be proposed (Grade C) under the guidance of a specialist in sexual disorders or an endocrinologist.
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