Paraphilias (Paraphilia)

Disorders that include recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving nonhuman objects, suffering of oneself or partners, or children or other nonconsenting partners. (from DSM-IV, 1994)

Also Known As:

Networked: 90 relevant articles (7 outcomes, 10 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pedophilia
2.	Exhibitionism
3.	Voyeurism
4.	Paraphilias (Paraphilia)
5.	Transvestism (Transvestic Fetishism)

Experts

1.	Briken, Peer: 4 articles (05/2013 - 05/2002)
2.	Bradford, John M W: 3 articles (06/2014 - 07/2003)
3.	Solla, Paolo: 2 articles (04/2015 - 12/2006)
4.	Cannas, Antonino: 2 articles (04/2015 - 12/2006)
5.	Thibaut, Florence: 2 articles (06/2014 - 04/2011)
6.	Fromberger, Peter: 2 articles (11/2011 - 11/2011)
7.	Müller, Jürgen Leo: 2 articles (11/2011 - 11/2011)
8.	Stolpmann, Georg: 2 articles (11/2011 - 11/2011)
9.	Jordan, Kirsten: 2 articles (11/2011 - 11/2011)
10.	Saleh, Fabian M: 2 articles (03/2010 - 11/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Paraphilias:

1.	Gonadotropin-Releasing Hormone (GnRH)FDA Link 08/01/2003 - "MEDLINE was searched for clinical trials, case-control studies, case reports, and other clinically and theoretically important literature published between 1980 and November 2002 on the treatment of paraphilia with LHRH agonists. " 03/01/2008 - "A 35-year-old man with a paraphilia was treated with long-acting gonadorelin. " 01/01/2007 - "A 35-year-old man with a paraphilia was treated with long-acting gonadorelin. " 08/01/2003 - "Although there is a need for further research, LHRH agonists offer a treatment option for patients with severe paraphilia. " 05/01/2002 - "A patient with multiple paraphilias had been successfully treated for 10 years with a long-acting LHRH agonist with complete suppression of deviant sexual activity. "
2.	Cyproterone AcetateIBA 05/01/2011 - "Cyproterone acetate in paraphilia." 10/01/1993 - "Cyproterone acetate is a powerful antiandrogen used in the treatment of the paraphilias for at least a decade. " 10/01/1993 - "Double-blind placebo crossover study of cyproterone acetate in the treatment of the paraphilias." 01/01/1974 - "[Treatment of sex deviations with cyproterone acetate]." 08/01/2001 - "A new class of antiandrogen medications, gonadotropin-releasing hormone agonists, offers promise in the treatment of the paraphilias, with substantially less side effects than medroxyprogesterone acetate or cyproterone acetate. "
3.	Testosterone (Sustanon)FDA Link 03/01/2008 - "Observational studies suggest that agents that lower testosterone are an effective treatment for paraphilia. " 11/01/2011 - "On the basis of the current knowledge about testosterone and its effects on brain and behavior as described in Part I, and of available results on the relationship between testosterone and paraphilia as well as antiandrogen therapy, we present from a neurobiological perspective an extended scientific proposal for design features to investigate the effects of antiandrogen treatment in large clinical trials." 11/01/2011 - "The role of testosterone in sexuality and paraphilia--a neurobiological approach. " 11/01/2011 - "We discuss endocrinological, neurobiological, and therapeutic aspects of paraphilia with the aim of integrating these on the basis of the current neurobiological and clinical knowledge on testosterone that was set out in Part I of this review. " 11/01/2011 - "Part II: testosterone and paraphilia."
4.	Medroxyprogesterone Acetate (Depo-Provera)FDA LinkGeneric 05/01/1993 - "There are no reports on the use of low-dose oral medroxyprogesterone acetate (MPA) in the treatment of the paraphilias. " 05/01/1993 - "Low-dose oral medroxyprogesterone acetate in the management of the paraphilias." 01/01/1989 - "The paraphilias and Depo-Provera: some medical, ethical and legal considerations." 11/01/1985 - "To examine the possible effect of progesterone on circulating T4-binding globulin (TBG) in men, RIA measurements of plasma TBG and T4 levels were made before and after weekly administration of 500 mg medroxyprogesterone acetate, im, to men being treated for paraphilia (sexual deviation syndromes). " 08/01/2001 - "A new class of antiandrogen medications, gonadotropin-releasing hormone agonists, offers promise in the treatment of the paraphilias, with substantially less side effects than medroxyprogesterone acetate or cyproterone acetate. "
5.	Fluoxetine (Prozac)FDA LinkGeneric 01/01/1998 - "We therefore describe an adolescent sex offender who met DSM-IV criteria for multiple paraphilias (except for the age criterion), bipolar type II disorder, and OCD, whose paraphilic urges and behaviors, depression, and violent obsessions responded to open label fluoxetine after failing to respond to long-term residential treatment. " 01/01/1998 - "An adolescent male with multiple paraphilias successfully treated with fluoxetine." 10/01/1992 - "Fluoxetine treatment of nonparaphilic sexual addictions and paraphilias in men." 04/01/1991 - "Three cases are presented in which fluoxetine was employed in the apparently successful treatment of paraphilia, a disorder which has been difficult to treat pharmacologically. " 04/01/1991 - "Three cases of paraphilias responsive to fluoxetine treatment."
6.	Triptorelin (Trelstar)FDA Link 02/12/1998 - "In an uncontrolled observational study, we treated 30 men (mean age, 32 years) with severe long-standing paraphilia (25 with pedophilia and 5 with other types of abnormal behavior) with monthly injections of 3.75 mg of triptorelin and supportive psychotherapy for 8 to 42 months. " 02/12/1998 - "Continuous administration of triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone, together with supportive psychotherapy, may be an effective treatment for men with severe paraphilia." 01/01/2007 - "[Side effects of treatment with the long-acting gonadorelin agonist triptorelin in a case of paraphilia]." 06/01/1993 - "Six men with severe paraphilia had been treated with depot gonadotrophin luteinizing releasing hormone analogue (GnRHa) (triptorelin 3.75 mg per month intramuscularly). " 03/01/2008 - "Side effects of pharmacotherapy on bone with long-acting gonadorelin agonist triptorelin for paraphilia."
7.	Androgen Antagonists (Antiandrogens)IBA 02/01/1968 - "[Throughts and considerations on the treatment of sex deviation psychopaths with antiandrogens]." 08/01/2003 - "Keywords included LHRH agonists, GnRH- agonists, antiandrogens, paraphilia, pedophilia, and sex offenders. " 02/12/1998 - "Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are often ineffective. " 01/01/2002 - "Earlier antiandrogens (e.g., estrogen, progesterone, and cyproterone acetate) have demonstrated efficacy in the treatment of paraphilias. " 01/01/2009 - "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. "
8.	Leuprolide (Lupron)FDA LinkGeneric 11/01/2004 - "This preliminary case series supports the conclusion that leuprolide deserves further examination as a potentially safe and effective component in the treatment of young adult patients with paraphilia." 11/01/2004 - "Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series." 08/01/2001 - "Leuprolide acetate shows promise as a treatment for the paraphilias." 08/01/2001 - "Depot-leuprolide acetate for treatment of paraphilias: a report of twelve cases." 07/01/2003 - "This pilot study represents a case series of seven patients diagnosed with severe paraphilias and treated with CPA, leuprolide, or surgical castration. "
9.	LithiumIBA 10/01/2000 - "Lithium for paraphilias? " 10/01/2000 - "Use of lithium and depot neuroleptics in the treatment of paraphilias." 02/01/1991 - "Nine of 10 consecutively evaluated men with DSM-III-R nonparaphilic sexual addictions or paraphilias noted improvement in sexual behaviors and depressive symptomatology while treated with fluoxetine, imipramine, or lithium. " 10/01/1998 - "Antiandrogen hormones, phenothiazines, and lithium therapy of paraphilias is briefly reviewed. "
10.	Estrogens (Estrogen)FDA Link 01/01/2002 - "Earlier antiandrogens (e.g., estrogen, progesterone, and cyproterone acetate) have demonstrated efficacy in the treatment of paraphilias. " 01/01/2009 - "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. " 12/01/2008 - "Search terms included aged, hypersexuality, sexual disorders, paraphilia, sexual behaviors, tricyclic antidepressants, selective serotonin reuptake inhibitors, medroxyprogesterone acetate, cyproterone acetate, estrogens, LHRH agonists, leuprolide, and triptorelin. "

Therapies and Procedures

1.	Combined Modality Therapy 11/01/2004 - "Though there is no known cure for these conditions, paraphilias can be effectively managed using a multimodal treatment approach. "
2.	Drug Therapy (Chemotherapy) 04/16/2011 - "Current concepts in the pharmacotherapy of paraphilias." 08/01/2003 - "In addition to psychotherapy, pharmacotherapy is an important treatment option for paraphilias, especially in sexual offenders. " 09/01/2000 - "SSRI pharmacotherapy (mean +/- SD duration = 8.8+/-11.1 months) had statistically significant effects in diminishing paraphilia/PRD-related total sexual outlet (p < .001) and average time/day spent in paraphilia/PRD sexual behavior (p < .001). " 09/01/2000 - "The indications for the addition of a psychostimulant to a stable dose of SSRI included the retrospective diagnosis of ADHD with persistent adult symptoms despite pharmacotherapy with an SSRI (N = 17); residual paraphilia/PRD fantasies, urges, and activities despite SSRI pharmacotherapy (N = 16); the persistence or presence of residual depressive symptoms despite SSRI pharmacotherapy (N = 6); relapse or loss of SSRI efficacy during the treatment of sexual impulsivity disorders (N = 4); and treatment of SSRI-induced side effects (N = 4). " 01/01/2000 - "Pharmacotherapy of paraphilias in the next millennium."
3.	Injections 02/12/1998 - "In an uncontrolled observational study, we treated 30 men (mean age, 32 years) with severe long-standing paraphilia (25 with pedophilia and 5 with other types of abnormal behavior) with monthly injections of 3.75 mg of triptorelin and supportive psychotherapy for 8 to 42 months. "
4.	Castration 07/01/2007 - "Physical eunuchs had a nonsignificant tendency to have masochistic paraphilia involving genital mutilation in advance of their castration (P < 0.1). " 07/01/2007 - "Participants answered questionnaire items pertaining to their knowledge about androgen deprivation, the nature of their castration, and the length of time between initial presentation of castration paraphilia and castration. " 01/01/2007 - "This article compares the motivations for, and responses to, castration between two groups of males: prostate cancer patients and voluntary modern-day eunuchs with castration paraphilias or other emasculating obsessions. " 01/01/2011 - "This chapter reviews the literature on surgical castration of sex offenders, anti-androgen use and the rationale for providing androgen deprivation therapy, rather than selective serotonin reuptake inhibitors or more conservative interventions, for patients with paraphilias and excessive sexual drive. " 07/01/2003 - "This pilot study represents a case series of seven patients diagnosed with severe paraphilias and treated with CPA, leuprolide, or surgical castration. "
5.	Amputation 09/01/2005 - "The literature suggests that self-amputation is an outgrowth of either psychosis or paraphilia. " 06/01/2005 - "Desire for amputation of a limb: paraphilia, psychosis, or a new type of identity disorder." 06/01/2006 - "Desire for amputation of a healthy limb has usually been regarded as a paraphilia (apotemnophilia), but some researchers propose that it may be a disorder of identity, similar to Gender Identity Disorder (GID) or transsexualism. " 06/01/2006 - "Similarities between the desire for limb amputation and nonhomosexual male-to-female (MtF) transsexualism include profound dissatisfaction with embodiment, related paraphilias from which the conditions plausibly derive (apotemnophilia and autogynephilia), sexual arousal from simulation of the sought-after status (pretending to be an amputee and transvestism), attraction to persons with the same body type one wants to acquire, and an elevated prevalence of other paraphilic interests. "