Compulsive-Impulsive Sexual Behaviors (C-ISBs) include repetitive sexual acts and compulsive sexual thoughts which occur so frequently and with such intensity that they interfere with sexual intimacy and interpersonal and occupational functioning and whose categorization and effective treatments are still unclear. We report the case of a patient affected by C-ISBs and bipolar disorder of type II who improved dramatically after three months' addition of topiramate to citalopram. Topiramate is a powerful anticonvulsant which has recently been proposed also for the treatment of migraine, bipolar disorder and binge eating disorder. This case-report suggests that topiramate might be beneficial in augmentation with citalopram in patients suffering from C-ISBs, although controlled studies to confirm our findings are needed.