Pharmacologic treatment of paraphilias.

Research paper by Alessandra Almeida AA Assumpção, Frederico Duarte FD Garcia, Heloise Delavenne HD Garcia, John M W JM Bradford, Florence F Thibaut

Indexed on: 01 Jun '14Published on: 01 Jun '14Published in: Psychiatric Clinics of North America


The treatment of paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of paraphilia and in cases of sexual compulsions and juvenile paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed.