Differential pharmacological treatment of paraphilias and sex offenders.
This article gives an overview of current pharmacological treatment of paraphilias and sex offenders focusing on the situation in Germany. Information about selective serotonin reuptake inhibitors (SSRI) is followed by data about established antihormonal substances (cyproterone acetate/CPA, and medroxyprogesterone acetate/MPA), as well as a more detailed account on luteinizing hormone-releasing hormone agonists (LHRH agonists). The results of open, uncontrolled clinical studies with SSRIs (n = 16) and LHRH agonists (n = 11) in paraphilic outpatients confirm the positive effects of these substances. A survey about the use of CPA and LHRH agonists in forensic hospitals in Germany shows that half of the patients treated with any kind of (anti-) hormonal agents received an LHRH agonist. The authors present a protocol on side effects, contraindications, and monitoring of CPA and LHRH agonists and develop an algorithm for differential pharmacotherapy of paraphilias.
Hill
Andreas
A
Klinik fuer Psychiatrie und Psychotherapie, Abteilung für Sexualforschung und Forensik, Universitaetsklinikum Hamburg Eppendorf, Hamburg D-20246, Germany.
Briken
Peer
P
Kraus
Christian
C
Strohm
Kerstin
K
Berner
Wolfgang
W
D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000819:agonists*; D006801:Humans; D008297:Male; D010262:Paraphilic Disorders / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012742:Sex Offenses / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D016896:Treatment Outcome
D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone; D017367:Selective Serotonin Reuptake Inhibitors