Oxcarbazepine is an anticonvulsant, also applicated in psychiatric disorders, particularly in mood disorders. Oxcarbazepine may be used to reduce aggressive and impulsive behaviors, too. Paraphilias present a close comorbidity with Obsessive Compulsive spectum, social phobia and mood disorders (bipolar spectrum). Mood stabilizer has been successfully used in a few cases of paraphilia. In this report, we describe about a paraphilic patient treated with oxacarbazepine.

M. is a young man, treated since a long time for a schizoaffective disorder. Before, he has been treated with psychopharmacological therapy based on classic and atypical neuroleptics. The patient presents a positive history for paraphilic thoughts, urges and abnormal sexual attitudes as voyeurism, exhibitionism, pornophilia with compulsive and repetitive masturbations. Paraphilic ideas were daily presents, and the behaviors were serially committed.

The patient withdraws the previous pharmacological therapy, and oxcarbamazepine is titrated up to 900 mg per day, for 36 mounths. After 3 mounths of treatment, the frequency of sexual deviant urges and thoughts was slightly reducted and after 6 months of treatment didn’t occur any paraphilic behavior. This absence permained for the followed 30 mounths.

While serotoninergic drugs reduce paraphilic thoughts and ideas, and antiandrogens decrease deviant attitudes with a complete reduction in sexaul desire. Oxcarbazebine could reduce the urges to act, with an increase in the control of this pulsion, as it just shown to be useful in aggressive acts. Further controlled trials may better clarify the possibile role of oxcarbazepine in patients affected by paraphilia.