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Medroxyprogesterone treatment for paraphiliacs
H M Kravitz1, T W Haywood, J Kelly
1Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1995
Summary
Medroxyprogesterone acetate (MPA) effectively reduced sexual drive and deviant behaviors in paraphilic men within six months. Clinicians should consider collateral information due to potential self-report bias in assessing treatment outcomes.
Area of Science:
- Endocrinology
- Psychiatry
- Pharmacology
Background:
- Paraphilic disorders are characterized by persistent sexual interests or behaviors that are distressing or harmful.
- Medroxyprogesterone acetate (MPA), a synthetic progestin, is used to suppress sexual drive by reducing testosterone levels.
Purpose of the Study:
- To evaluate the efficacy and safety of MPA in treating paraphilic men.
- To assess the impact of MPA on sexual drive, behavior, and testosterone levels.
- To identify essential components of MPA pretreatment evaluations and potential side effects.
Main Methods:
- A cohort of 29 paraphilic men received MPA (Depo-Provera) and group therapy.
- Weekly self-reported psychosexual inventories measured sexual drive and activities.
- Testosterone levels were monitored pretreatment and at three and six months.
Main Results:
- MPA demonstrated a differential suppression of sexual activities, with deviant behaviors suppressed faster than nondeviant ones.
- Testosterone levels were significantly reduced to below 0.5 ng/mL in most subjects within six months.
- One subject experienced pulmonary emboli; otherwise, MPA was generally well-tolerated with no major medical issues.
Conclusions:
- MPA is safe and effective in reducing sex drive and controlling deviant sexual impulses in paraphilic men.
- The rapid and complete response suggests potential for self-report bias, necessitating collateral information.
- Longer follow-up studies are needed to confirm sustained treatment efficacy.