The control of deviant sexual behavior by drugs: a double-blind controlled study of benperidol, chlorpromazine, and placebo

Only one small included study assessed antipsychotics (Tennent 1974).

“only one small study assessed antipsychotics (Tennent 1974).”

In Tennent 1974, new participants were brought in to replace those that dropped out so that outcome data appear for 12 participants, but not those who were recruited.

“New participants were brought in to replace those that dropped out so that outcome data appear for 12 participants, but not those who were recruited.”

With the exception of Bancroft 1974 and Tennent 1974, who used Williams square designs, no included study authors described their methods of randomisation.

“With the exception of Bancroft 1974 and Tennent 1974, who used Williams square designs, no study authors described their methods of randomisation;”

Three studies (Bancroft 1974; Tennent 1974; Hucker 1988) were assessed as having an overall low risk of bias given measures taken to blind staff or assessors to group allocation.

“We assessed three studies as having an overall low risk of bias given the measures taken to blind staff or assessors to group allocation (Bancroft 1974; Tennent 1974; Hucker 1988).”

Tennent 1974 compared benperidol with chlorpromazine (both antipsychotics) and placebo.

“Tennent 1974 compared benperidol with chlorpromazine (both antipsychotics) and placebo.”

In two included studies conducted in a high security facility, recidivism data could not be collected because participants were not due to be released for some years, if ever (Bancroft 1974; Tennent 1974).

“Two studies were both conducted in a high security facility from which participants were not due to be released for some years, if ever (Bancroft 1974; Tennent 1974). Recividism data therefore could not be collected.”

In Tennent 1974, it is unclear which phases of the study saw the loss of three participants who withdrew or were withdrawn early.

“Within a similar study conducted in the same setting (Tennent 1974), it is unclear which phases of the study saw the loss of three participants who withdrew or were withdrawn early in the study (for depression or other reasons).”

Care in blinding treating staff and participants by means of an off-site pharmacist using coded bottles of identical intervention and placebo pills was clearly reported in Bancroft 1974 and Tennent 1974.

“Care in blinding treating staff and participants by means of an off-site pharmacist using coded bottles of identical intervention and placebo pills was clearly reported in the two oldest studies in the review (Bancroft 1974; Tennent 1974);”

Blurred vision, photosensitivity, dry mouth, and impaired exercise tolerance were reported for both drugs.

“Blurred vision, photosensitivity, dry mouth, and impaired exercise tolerance were also reported for both drugs.”

Chlorpromazine was ineffective (Tennent 1974).

“Results indicated that chlorpromazine was ineffective”

Carry-over effects were not investigated directly in the study comparing benperidol and chlorpromazine against placebo.

“Carry-over effects were not investigated directly, although an unplanned, no treatment phase (which occurred when the active interventions were changed from syrup to tablet forms) allowed additional data to be collected.”

In terms of measures of participants' arousal during erotic stimuli, no significant differences between drugs (or placebo) could be detected (Tennent 1974).

“but in terms of measures of participants' arousal during erotic stimuli, no significant differences between drugs (or placebo) could be detected.”

Five different drugs were used: two in head-to-head trials, three against placebo alone, and two where the drug was augmented with a psychological intervention and compared against the psychological intervention on its own.

“Five different drugs were used, two of which were in 'head-to-head' (active treatment comparison) trials (Bancroft 1974; Tennent 1974); three against placebo alone (Cooper 1981; Hucker 1988; Bradford 1993); and two where the drug was augmented with a psychological intervention and compared against the psychological intervention on its own (Langevin 1979; McConaghy 1988).”

The effects of antipsychotics were assessed in one study on only 12 participants (Tennent 1974).

“The effects of antipsychotics were assessed in one study on only 12 participants (Tennent 1974).”

Benperidol was associated with considerably more dyskinetic extra-pyramidal side effects than chlorpromazine.

“Results appear to indicate that benperidol was associated with considerably more dyskinetic extra-pyramidal side effects than chlorpromazine”

Three participants left the study early (two within the first week, of their own volition; a third was withdrawn due to severe depression).

“Three participants left the study early (two within the first week, of their own volition; a third was withdrawn due to severe depression).”

Chlorpromazine was slightly superior to benperidol in terms of drowsiness.

“but that chlorpromazine was slightly superior in terms of drowsiness.”

Benperidol had (at best) a weak libido-reducing effect (Tennent 1974).

“and that benperidol had (at best) a weak libidoreducing effect.”

Erections when viewing erotic slides or films were counted and there were no significant differences between conditions ((F < 1.0) in both cases; investigators' analyses).

“Erections when viewing erotic slides or films were counted and there were no significant differences between conditions ((F &lt; 1.0) in both cases; investigators' analyses).”

Two studies included within this review took place in one highly secure psychiatric facility where participants' chance of release into the community was low, so collection of recidivism data was impossible (Bancroft 1974; Tennent 1974).

“Two studies included within this review took place in one highly secure psychiatric facility where participants' chance of release into the community was low, so collection of recividism data was impossible (Bancroft 1974; Tennent 1974).”

Six studies provided information on adverse events (Bancroft 1974; Tennent 1974; Langevin 1979; Hucker 1988; McConaghy 1988; Bradford 1993).

“Six studies provided information on adverse events (Bancroft 1974; Tennent 1974; Langevin 1979; Hucker 1988; McConaghy 1988; Bradford 1993).”

Except for the Tennent study, which used typical neuroleptics, the other studies employing testosterone-lowering interventions or oestrogens all showed a positive effect in reducing various components of the sexual process.

“This is relevant as, except for the Tennent study (Tennent 1974), which used typical neuroleptics, the other studies employing testosterone-lowering interventions or oestrogens all showed a positive effect in reducing various components of the sexual process.”

One quarter (3/12) of the participants of the one trial assessing the effects of antipsychotics left the study, two of their own volition and one because of depression (Tennent 1974).

“One quarter (3/12) of the participants of the one trial assessing the effects of antipsychotics left the study, two of their own volition and one because of depression (Tennent 1974).”

Few studies could be considered to have adequate sequence generation.

“few could be considered to have adequate sequence generation (Bancroft 1974; Tennent 1974)”

In Tennent 1974, allocation concealment (selection bias) was judged at unclear risk.

“Allocation concealment (selection bias) | Unclear risk”

In Tennent 1974, random sequence generation (selection bias) was judged at low risk.

“Random sequence genera- tion (selection bias) | Low risk”

In Tennent 1974, blinding of outcome assessment (detection bias) for all outcomes was judged at low risk.

“Blinding of outcome as- sessment (detection bias) All outcomes | Low risk”

In Tennent 1974, the sexual interest self-report measure was judged not to be a measure of deviant urges.

“We judged that this was not a measure of”

In Tennent 1974, blinding of participants and personnel (performance bias) for all outcomes was judged at low risk.

“Blinding of participants and personnel (perfor- mance bias) All outcomes | Low risk”