In partnership with The Homewood Foundation, the American Foundation for Addition Research and Vanderbilt University have begun the initial phase of a unique five-year research project to learn more about the relationship of sexual arousal, brain chemistry, and addiction, and the effectiveness of selective serotonin reuptake inhibiting (SSRI) medications such as Prozac, Zoloft, and Paxel.

The initial phase of this unique joint research project began in January 2000. "The objective of the study’s first phase is to develop a Functional Magnetic Resonance Imaging (fMRI) map of the brain regions that are activated during sexual arousal in normal male volunteers as a precursor in studies in patients with sexual arousal disorders," said Vanderbilt’s Peter Martin, M.D., the project’s director. fMRI imaging provides non-invasive high resolution activation maps of the visual cortex, motor cortex, and other brain systems, including those activated with administration of drugs of abuse.

In the study’s second phase, researchers hope to (1) determine the fMRI map of the brain regions that are activated during sexual arousal in normal female volunteers as a precursor I patients with sexual arousal disorders, and (2), determine the fMRI map of the brain regions that are activated during sexual arousal and cue-induced cocaine or alcohol craving in male and female patients who meet research diagnostic criteria for sexual addiction and cocaine or alcohol dependence.

"This project also seeks to identify the neurobiological basis of sexual addiction and its overlap with other addictive disorders, such as alcohol and cocaine dependence, and to identify pharmacological agents that may improve treatment outcome," said Elizabeth Griffin, AFAR Associate Director. Thus, in the study’s final phase, researchers will work to determine the effectiveness of SSRIs in patients with sexually compulsive behaviors.

"The fMRI studies in normal volunteers of both genders and sexual addiction patients garnered in this project could potentially serve to more accurately identify the brain systems that serve sexual functioning," explained Griffin. "In addition, they will help researchers determine the relationship of these brain systems to brain regions involved in cocaine and alcohol dependence." They may also lead to increasingly detailed future investigations of patients with sexual addiction, as well as to future investigations of new agents that reduce craving and prevent relapse in patients with sexual addiction.

Vanderbilt University and the American Foundation for Addiction Research plan to publish their research findings as well as use them as part of an international conference on the biology of addictions which AFAR plans to host in 2001.

Pivotal research development meeting held

On February 4th and 5th, AFAR hosted a landmark gathering of some of the world’s leading researchers in the fields of human behavioral science and human sexual disorders. Hosted by the Division of Addiction Medicine at Vanderbilt University and led by Dr. Peter Martin and Dr. Paul Ragan, psychiatrists, psychologists, psychiatric nurses, counselors, and physicians came together to examine and provide direction for AFAR research on sexually compulsive or out-of-control behavior.

According to participant Dr. David Delmonico of Duquesne University, those attending sought to determine directions for future research, funding priorities, and other activities that, taken together, would be most effective in helping treat people struggling with this problem. "I believe I can speak for everyone when I say that we all found it extremely valuable to hear the problem addressed from these different perspectives. We all recognized that while we may use different words to describe this problem, we all have a similar goal—to increase our knowledge of the problem and to develop better ways to treat people who struggle with it. It is clear that this is a serious problem that must be comprehensively addressed with a multi-dimensional approach."

Participants also spent much time discussing the Vanderbilt research project and its implications for the field and for understanding the problem of sexually out-of-control behavior. "This study is so significant because it is really the first attempt ever made to discover a biological link for this behavior," said Delmonico, "and it may help us take the first step in gaining a more clear understanding of the biological factors."

Meeting participants included Fred Berlin, M.D., David Dodd, M.D., Aviel Goodman, M.D., Eric Hollander, M.D., Richard Irons, M.D., Peter Martin, M.D., Paul Ragan, M.D., Jennifer Schneider, M.D., Andy Spickard, M.D., Karen Starr, M.S.N., and William Swiggart, M.S., David Delmonico, Ph.D., Reid Finlayson. M.D., Martin Kafka, M.D., Jeff Seat, Ph.D., and Mark Nickel, M.A., and Mitchell Parks, M.D., who are conducting the fMRI testing at Vanderbilt.