Concerns about
paraphilia and its treatment have grown in the past few years. Although the aetiology of
paraphilia disorder is still not completely understood, pharmacological treatments have been proposed for this disorder.
Paraphilias are a major burden for patients and society; nevertheless, only a few individuals with
paraphilias voluntarily seek treatment.
Antidepressants have been used in the treatment of certain types of mild (e.g.
exhibitionism) and juvenile
paraphilias. Antilibidinal hormonal treatments, such as steroidal
antiandrogens and gonadotrophin-releasing
hormone (
GnRH) analogues, have also been studied and they seem to be effective in
paraphilic disorders, although caution should be taken in the prescription of these treatments in order to avoid or minimize adverse effects and the risk of victimization. The combination of psychotherapy and pharmacological
therapy is associated with better efficacy compared with either treatment as monotherapy.
Paraphilia is a chronic disorder and a minimal
duration of treatment of 3-5 years is highly recommended for severe
paraphilia with a high risk of sexual violence. In conclusion, this review of the literature provides suggestive evidence that
paraphilias are well characterized disorders marked by pathological dimensions. Although further research is necessary to confirm treatment efficacy and to improve our knowledge of long-term tolerance, available data on the use of
selective serotonin reuptake inhibitors, steroidal
antiandrogens and
GnRH analogues strongly suggest the efficacy of these treatments for
paraphilic disorders.