Pharmacological treatments for paraphilic patients and sexual offenders.
OBJECTIVE
This review addresses testosterone-lowering and other psychotropic medications for the treatment of paraphilic patients or sexual offenders.


RESULTS
Randomized controlled studies are still lacking, and only a few new studies were reported during the past year. On the other hand, there is substantial scientific knowledge about the wide range of psychiatric comorbidity associated with paraphilias and in sexual offenders. Empirically based treatment of these patients, especially of impulsivity, anxiety and mood disorders, may also ameliorate sexual impulsivity.


CONCLUSIONS
Medication interventions, either substantially lowering serum testosterone or treating axis I comorbidities, show definite promise as a significant component of the management of sexual offenders. Pharmacotherapy should be combined with other therapeutic treatment modalities, most commonly cognitive-behaviour based psychotherapy and intensive community supervision.
Briken
Peer
P
Institute for Sex Research and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. briken@uke.uni-hamburg.de
Kafka
Martin P
MP
D000726:Androgen Antagonists / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008525:Medroxyprogesterone / Q000627:therapeutic use; D010262:Paraphilic Disorders / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012742:Sex Offenses / Q000517:prevention & control* / Q000523:psychology; D013739:Testosterone / Q000037:antagonists & inhibitors*
D000726:Androgen Antagonists; D017373:Cyproterone Acetate; D008525:Medroxyprogesterone; D017367:Selective Serotonin Reuptake Inhibitors; D013739:Testosterone