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Depot-Leuprolide Acetate for Treatment of Paraphilias: A Report of Twelve Cases

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Abstract

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. This paper reports the results of treatment using a depot suspension of leuprolide acetate on 12 patients with paraphilic disorders or with sexual disorders not otherwise specified to suppress or help these individuals control their deviant sexual behavior or impulses. The method involved uncontrolled observations of individuals treated with depot-leuprolide acetate for various lengths of time, from 6 months to 5 years, with the follow-up intervals ranging from 6 months to 6 years. Leuprolide acetate resulted in a significant suppression of deviant sexual interests and behavior as measured by self-report and was well tolerated. However, the three patients who were on long-term therapy developed bone demineralization, suggesting that this is a significant side effect of prolonged therapy. Leuprolide acetate shows promise as a treatment for the paraphilias.

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REFERENCES

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., APA, Washington, DC.

    Google Scholar 

  • Appelbaum, P. S., and Gutheil, T. G. (1991). Clinical Handbook of Psychiatry and the Law, 2nd edn., Williams & Wilkins, Baltimore.

    Google Scholar 

  • Ascoli, M., and Segaloff, D. L. (1996). Adenohypophyseal hormones and their hypothalamic releasing factors. In Hardman, J., and Limbird, L. (eds.), Goodman&Gilman's The Pharmacological Basis of Therapeutics, McGraw-Hill, New York, pp. 1363-1382.

    Google Scholar 

  • Bradford, J. M. (1985). Organic treatment for the male sexual offender. Behav. Sci. Law 3: 355-375.

    Google Scholar 

  • Bradford, J. M. (1988). Organic treatment for the male sexual offender. In Prentky, R., and Quinsey, V. (eds.), Human Sexual Aggression: Current Perspectives, The New York Academy of Sciences, New York, pp. 193-202.

    Google Scholar 

  • Bradford, J. M. (1998). Treatment of men with paraphilia. N. Engl. J. Med. 338: 464, 465.

    Google Scholar 

  • Cooper, A. J., and Cernovsky, Z. Z. (1994). Comparison of cyproterone acetate (CPA) and leuprolide acetate (LHRH agonist) in a chronic pedophile: A clinical case study. Biol. Psychiatry 36: 269-271.

    Google Scholar 

  • Daniell, H.W., Dunn, S. R., Ferguson, D.W., Lomas, G., Niazi, Z., and Stratte, P. T. (2000). Progressive osteoporosis during androgen deprivation therapy for prostate cancer. J. Urol. 163: 181-186.

    Google Scholar 

  • Diamond,T., Campbell, J., Bryant, C., and Lynch, W. (1998). The effect of combined androgen blockade on bone turnover and bone mineral densities in men treated for prostatic carcinoma. Cancer 83: 1561-1566.

    Google Scholar 

  • Dickey, R. (1992). The management of a case of treatment-resistant paraphilia with a long-acting LHRH agonist. Can. J. Psychiatry 37: 567-569.

    Google Scholar 

  • Gijs, L., and Gooren, L. (1996). Hormonal and psychopharmacological interventions in the treatment of paraphilias: An update. J. Sex Res. 33: 273-290.

    Google Scholar 

  • Heim, N. (1981). Sexual behavior of castrated sex offenders. Arch. Sex. Behav. 10: 11-19.

    Google Scholar 

  • Hornstein, M. D., Surrey, E. S., Weisberg, G. W., and Casino, L. A. (1998). Leuprolide acetate depot and hormonal add-back in endometriosis: A 12-month study. Obstet. Gynecol. 91: 16-24.

    Google Scholar 

  • Kafka, M. P., and Prentky, R. A. (1998). Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders:Acomorbidity study. J. Clin. Psychiatry 59: 388-396.

    Google Scholar 

  • Rachman, M., Garfield, D. A. S., Rachman, I., and Cohen, R. (1999). Lurpon-induced mania. Biol. Psychiatry 45: 243, 244.

    Google Scholar 

  • Raymond, N. C., Coleman, E., Ohlerking, F., Christenson, G. A., and Miner, M. (1999). Psychiatric comorbidity in pedophilic sex offenders. Am. J. Psychiatry 156: 786-788.

    Google Scholar 

  • Rich, S. S., and Ovsiew, F. (1994). Leuprolide acetate for exhibitionism in Huntington's disease. Mov. Disord. 9: 353-357.

    Google Scholar 

  • Rosler, A., and Witztum, E. (1998). Treatment of men with paraphilia with a long-acting analogue of gonadotropin-releasing hormone. N. Engl. J. Med. 338: 416-422.

    Google Scholar 

  • Rousseau, L., Couture, M., Dupont, A., Labrie, F., and Couture, N. (1990). Effect of combined androgen blockade with and LHRH agonist and flutamide in one severe case of male exhibitionism. Can. J. Psychiatry 35: 338-341.

    Google Scholar 

  • Rousseau, L., Dupont, A., Labrie, F., and Couture, M. (1988). Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration. Arch. Sex. Behav. 17: 87-98.

    Google Scholar 

  • Smith, J. A., Glode, L. M., Max, D. T., Wettlaufer, J. N., Anbar, D., Stein, B. S., Jagst, C. L., Glass, A. G., and Murphy, G. P. (1985). Clinical effects of gonadotrophin-releasing hormone analogue in metastatic carcinoma of prostate. Urology 25: 106-114.

    Google Scholar 

  • Surrey, E. S., and the Add-Back Consensus Working Group. (1999). Add-back therapy and gonadotropin-releasing hormone agonists in the treatment of patients with endometriosis: Can a consensus be reached? Fertil. Steril. 71: 420-424.

    Google Scholar 

  • Thibaut, F., Cordier, B., and Kuhn, J.-M. ( 1993). Effect of a long-lasting gonadotrophin hormonereleasing hormone agonist in six cases of severe male paraphilia. Acta Psychiatr. Scand. 87: 445-450.

    Google Scholar 

  • Thibaut, F., Cordier, B., and Kuhn, J.-M. (1996). Gonadotrophin hormone releasing hormone agonist in cases of severe paraphilia: A lifetime treatment? Psychoneuroendocrinology 21: 411-419.

    Google Scholar 

  • Townsend, M. F., Sanders, W. H., Northway, R. O., and Graham, S. D. (1997). Bone fractures associated with luteinizing hormone-releasing hormone agonists used in the treatment of prostate carcinoma. Cancer 79: 545-550.

    Google Scholar 

  • Warnock, J. K., Bundren, J. C., and Morris, D. W. (1998). Sertraline in the treatment of depression associated with gonadotropin-releasing hormone agonist therapy. Biol. Psychiatry 43: 464, 465.

    Google Scholar 

  • Wei, J. T., Gross, M., Jaffe, C. A., Gravlin, K., Lahaie, M., Faerber, G. J., and Cooney, K. A. (1999). Androgen deprivation therapy for prostate cancer results in significant loss of bone density. Urology. 54: 607-611.

    Google Scholar 

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Krueger, R.B., Kaplan, M.S. Depot-Leuprolide Acetate for Treatment of Paraphilias: A Report of Twelve Cases. Arch Sex Behav 30, 409–422 (2001). https://doi.org/10.1023/A:1010213432606

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