The Impact of Sedative Hypnotic Drugs on Hallucinated Sexual Assault or Sexual Fantasies Involving Health Professionals: A Systematic Review

Abstract

AbstractThis article discusses the rare but serious occurrence of sedative hypnotic drug–induced sexual thoughts. We searched PubMed from the earliest date to February 7, 2023. Articles were selected if they provided data on sexual assault hallucinations or sexual fantasies associated with the use of sedative hypnotic drugs including benzodiazepines, propofol, nitric oxide, ether, chloroform, ketamine, or esketamine. Twenty‐two citations provided useful information, including 87 cases of hallucinations about sexual assault or sexual fantasy. In several of the cases, the environment and monitoring made the actual occurrence of sexual assault unlikely, but there was still significant anguish for the patients and the accused clinicians. In many of the cases, the places of the body where procedures were conducted coincided with the area of the body where the patients perceived the sexual assault or fantasy occurred. The higher the dose of sedative hypnotic administered, the greater the risk of experiencing a hallucination about sexual assault or sexual fantasy. The US Food and Drug Administration Adverse Events Reporting System has numerous occurrences in which “excessive sexual fantasies” and “abnormal dreams” were associated with the use of sedative hypnotic medication but also occurrences of “sexual abuse.” While sexual assault hallucinations or fantasies associated with sedative hypnotics are rare, it is imperative that health care providers take the necessary precautions and follow recommendations to provide safety for themselves and their patients.