Medicating Bill

Impeachment is a drawn-out and perhaps disproportionate punishment. George Stephanopoulos says Clinton will never resign. Censure is probably inadequate, and besides, the Republicans will never go for it. The New York Times today explores the psychotherapy option, but notes the lingering taboo for high-ranking public officials (remember Tom Eagleton and Michael Dukakis; the latter didn’t undergo psychotherapy, but the mere rumor that he had seen a shrink hurt his presidential campaign in 1988). And the Times completely ignores the threat this option would pose to the psychotherapist himself (see The President’s Analyst, a 1967 movie starring James Coburn).

Fortunately, we live in a golden age of psychopharmacology. Chatterbox consulted Dr. Ronald L. Kamm, M.D., an assistant clinical professor of psychiatry at Philadelphia’s MCP Hahnemann University School of Medicine (who wants it clear that he is not diagnosing the president). Chatterbox asked Dr. Kamm what medication he would recommend for “a friend” suffering from “compulsive hypersexuality,” defined by Dr. Kamm as “an obsessive preoccupation with non-deviant sexual thoughts or a compulsive pattern of sexual behavior to the point of social or occupational impairment.” Here’s what Dr. Kamm says that the local drug store has to offer:

Generic name: fluoxetine
Manufacturer: Lilly
Possible side effects: gastrointestinal upset; diminished sex drive; retarded ejaculation; anorgasmia.

Generic name: fluvoxamine
Manufacturer: Solvay
Possible side effects: same as Prozac, and also drowsiness.

Generic name: nefazodone
Manufacturer: Bristol-Myers Squibb
Possible side effects: nausea.

Serzone “is sometimes better tolerated” by compulsive heterosexuals than the antidepressants Prozac or Luvox, says Dr. Kamm, because it zeroes in on compulsive behavior without diminishing the libido. Taking it, he says, shouldn’t reduce sexual enjoyment or performance with regular partners (e.g., husband or wife).

Generic name: naltrexone
Manufacturer: DuPont
Possible side effects: should not be taken by patients suffering from hepatitis or liver failure.

An endorphin-blocker. Some people believe compulsive sexual behavior yields a rush that resembles an “opium high”; naltrexone is an “opioid antagonist.”

Generic name: buproprion
Manufacturer: Glaxo
Possible side effects: nausea.

This is often prescribed to help patients quit smoking.

If these don’t work, or if Newt Gingrich thinks this regimen is insufficiently punitive, Chatterbox, who is not a doctor but plays one on the Internet, recommends Upjohn’s Provera (progesterone). That’s the stuff that is sometimes prescribed for rapists and child molesters….

Timothy Noah