Gonadotrophin hormone releasing hormone agonist in cases of severe paraphilia: a lifetime treatment?

Abstract

Six patients with severe paraphilia were treated with a long-acting gonadotrophin hormone releasing hormone analogue (GnRH-a). In five cases, the antiandrogen treatment ended their deviant sexual behaviour and markedly decreased their sexual fantasies and activities without significant side-effects. The beneficial effects of this treatment were maintained for 7 years in the patient where there was the longest follow-up. Two patients abruptly withdrew front their antiandrogen treatment at the end of the first and third year, respectively. Both relapsed within 8-10 weeks. One of them asked for resumption of antiandrogen treatment. In another case, in order to phase out antiandrogen treatment, testosterone (T) was added to the GnRH-a. In spite of normal T levels, and of resumption of normal sexual activities and deviant fantasies, deviant sexual behaviour did not return. A smoother phasing out of GnRH-a treatment is thought to be better than an abrupt withdrawal. However, the duration of antiandrogen treatment necessary to ensure a complete disappearance of deviant sexual behaviour remains uncertain, but is at least 4 years.

• Authors: F Thibaut, B Cordier, J M Kuhn
• Journal: Psychoneuroendocrinology (Psychoneuroendocrinology) Vol. 21 Issue 4 Pg. 411-9 (May 1996) ISSN: 0306-4530 [Print] England
• PMID: 8844879 (Publication Type: Case Reports, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Delayed-Action Preparations
• Gonadotropin-Releasing Hormone
• Testosterone

Topics

• Adolescent
• Adult
• Bipolar Disorder (complications, drug therapy, psychology)
• Borderline Personality Disorder (drug therapy, psychology)
• Delayed-Action Preparations
• Exhibitionism (drug therapy, psychology)
• Gonadotropin-Releasing Hormone (administration & dosage, adverse effects, agonists)
• Humans
• Intellectual Disability (complications, psychology)
• Male
• Masturbation
• Paraphilic Disorders (drug therapy, psychology)
• Pedophilia (psychology)
• Personality Disorders (drug therapy, psychology)
• Psychiatric Status Rating Scales
• Recurrence
• Substance Withdrawal Syndrome (psychology)
• Testosterone (blood)