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Cited by 129Psychopathy, Forensic Psychiatry, Sexual OffendingSexuality, Behavior, and TechnologySexual function and dysfunction studies

Drug treatment of paraphilic and nonparaphilic sexual disorders

Guay, David R.P.·2009·Clinical Therapeutics
DOI 10.1016/j.clinthera.2009.01.009
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Abstract

Background Paraphilias are characterized by recurrent, intense, sexually arousing fantasies, urges, or behaviors, over a period of > or =6 months, generally involving nonhuman objects, suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons. These fantasies, urges, and behaviors produce clinically significant distress or impairments in social, occupational, and other important areas of functioning. Objective The goal of this article was to provide an in-depth review of the clinical pharmacology of the main antiandrogens (cyproterone acetate, medroxyprogesterone acetate [MPA], and the luteinizing hormone-releasing hormone [LHRH] agonists) used in the treatment of the paraphilias, as well as a discussion of the relevant clinical case reports, case series, and controlled trials. Treatment recommendations are also provided. Methods Relevant publications were identified through a search of the English-language literature indexed on MEDLINE/PubMed (1966-September 2008) using the search terms paraphilia, sex offender, hypersexuality, sexual behaviors, fetish, transvestic fetishism, sexual addiction, sexual compulsivism, selective serotonin reuptake inhibitors, tricyclic antidepressants, antiandrogens, cyproterone acetate, medroxyprogesterone acetate, LHRH agonists, and estrogens. Additional publications were identified from the bibliographies of retrieved publications. Results In vitro and in vivo (animal) studies have revealed that serotonin…

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  • Two recent literature reviews focused on drug treatments for both paraphilic and non-paraphilic sexual disorders (Guay 2009) and for paraphilic disorders alone (Garcia 2011).

    “More recently, two relevant literature reviews have appeared focusing on drug treatments for both paraphilic and non-paraphilic sexual disorders (Guay 2009) and for paraphilic disorders alone (Garcia 2011).”

    From Pharmacological interventions for those who have sexually offended or are at risk of offending (2015) · cites this paper as Guay 2009

  • Neither of these two reviews restricted itself to trials of any particular study design, and neither searched more than two databases.

    “Neither restricted itself to trials of any particular study design; neither searched more than two databases;”

    From Pharmacological interventions for those who have sexually offended or are at risk of offending (2015) · cites this paper as Guay 2009

  • Both of these reviews indicated that treatment looked promising but that the state of the intervention literature was poor.

    “both indicated that treatment looked promising but that the state of the intervention literature was poor.”

    From Pharmacological interventions for those who have sexually offended or are at risk of offending (2015) · cites this paper as Guay 2009

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Authors
Guay, D. R. P.
Affiliations
University of Minnesota (US)
Corresponding author
Guay, David R.P.
ORCID
Guay, David R.P.
Venue
Clinical Therapeutics
Publisher
Elsevier BV
Published
2009-01
Volume
31
Issue
1
Pages
1-31
ISSN
0149-2918 (ISSN-L)
DOI
10.1016/j.clinthera.2009.01.009
OpenAlex
W1990765545
Cited by
129
References
3
Citations by year
2026: 2 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 4 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 15 · 2013: 10 · 2012: 8
FWCI
1.53
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
paraphilias, pharmacotherapy, androgen receptor antagonists, cyproterone acetate, medroxyprogesterone acetate, GnRH agonist, selective serotonin reuptake inhibitors, tricyclic antidepressants, serotonin, testosterone, hypersexuality, pedophilia, sexual addiction, cognitive behavioral therapy
MeSH terms
Androgen Antagonists, Animals, Clinical Trials as Topic, Female, Humans, Gonadotropin-Releasing Hormone, Male, Paraphilic Disorders, Sex Offenses, Sexual Dysfunctions, Psychological

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