NCJ Number
207007
Journal
Journal of Child Sexual Abuse Volume: 12 Issue: 3/4 Dated: 2003 Pages: 233-253
Date Published
2003
Length
21 pages
Annotation
This article reviews data on the effectiveness and tolerability of the testosterone-lowering agents medroxprogesterone acetate, cyproterone acetate, and leuprolide acetate in treating men with paraphilic disorders, which are psychiatric syndromes characterized by deviant sexual thoughts, cravings, urges, and/or behaviors.
Abstract
After reporting on two cases in which testosterone-lowering agents improved the functioning of patients with debilitating sexual fantasies and behaviors, this article reviews the fundamental biochemical aspects of the serotonin and catecholamine systems, followed by a review of studies relevant to the discussion of sexual phenomenology. In discussing the role of sex hormones in paraphilic disorders, the focus is on males, since paraphilias are rare in women. Data from pharmacological and castration studies provide evidence that supports the regulatory effects of androgens on sexual drive, interest, and behavior. The goal of therapy, notably cognitive-behavioral therapy, is to help patients learn to control inappropriate sexual thoughts and behaviors, gain empathy for victims, and develop effective relapse prevention strategies. Psychopharmacological therapies have not only proven to be valuable but are sometimes indispensable in the treatment and management of paraphilic patients. The drugs used in the treatment of the paraphilias can be divided into two groups: testosterone-lowering medications and the serotonergic antidepressants. This article discusses the biological processes and effects of these drugs. The article concludes that the treatment of paraphilic patients should always be broad and multifaceted, including psychosexual therapies and, if indicated, pharmacological treatment. 104 references