In the early 1960s, Neumann and his colleagues in West Berlin, working experimentally with rats, discovered the antiandrogenic properties of cyproterone and cyproterone acetate (Neumann, Elger, Steinbeck and von Berswordt-Wallrabe, 1968). Shortly thereafter, clinical application of the new drug to human beings was begun investigatively on a small scale in selected clinics in West Germany and Switzerland (Laschet et al., 1967; Koffet, 1968; Seebandt, 1968). Among the patients chosen for treatment were sex offenders, that is men whose self-regulation of publicly and legally unacceptable sexual behavior was so severely impaired that their only alternative was long-term incarceration. In a parallel investigation with another drug, methyloestrenolone (19-nor- 17a-methyltestosterone), Servais (1968) in Belgium also obtained therapeutic results. See also Hubin and Servais (1968). In women the drug has an antiovulatory effect. In the United States at that time, as now, cyproterone was not released by the Federal bureaucracy of the Food and Drug Administration (FDA) for behavioral research. It has been possible, however, to substitute medroxyprogesterone acetate (Provera?, Upjohn), a synthetic steroid most widely known for its progestinic effect, but known also to have a counteractive effect on the sex hormones in cases of idiopathic sexual precocity. Claude Migeon, M.D. and his assistant Marco Rivrola, M.D., and I made a decision to try therapy with Depo-Provera? when a bisexual transvestite patient under long-term followup study underwent a crisis of pedophilia, fellatio and incest with his six year old son (Money, 1969; and Case Illustration, below). * Supported in Research by Grant ?HD-00325 and Research Career Development Award #HD-K3-18,635, United States Public Health Service. I also wish to acknowledge the assistance of Mr. Ronald J. Gaskin in the abstracting of case histories and the preparation Table 1. The material of this paper will appear in The Treatment of the Sexual Offender (H. L. P. Resnick and M. Wolfgang, eds.), Boston, Little Brown. In press.

Use of an Androgen‐Depleting Hormone in the treatment of male sex offenders∗

Interest in the pharmacotherapeutic treatment of paraphilias is growing. Two classes of drugs have been tested: drugs that interfere with the normal production and action of androgens and psychotro...

Hormonal and psychopharmacological interventions in the treatment of paraphilias: An update

Treatment of adult male rats with oestradiol, cyproterone acetate or cyproterone affected spermatogenesis, accessory sexual glands and fertility in different ways. Suppression ofLeydig cells, spermatogenesis, accessory sexual glands and fertility ran parallel in oestradiol-treated animals. High doses of cyproterone acetate caused severe suppression of the accessory sexual glands and fertility but had only a slight inhibitory influ-

/pdf/comparison-of-the-effects-of-cyproterone-cyproterone-acetate-4onf9odxk5.pdf

Comparison of the effects of cyproterone, cyproterone acetate and oestradiol on testicular function, accessory sexual glands and fertility in a long-term study on rats

A minority of people with mental retardation have sexual behaviour which is socially unacceptable or which brings them into conflict with the law. Such behaviour may be the result of ignorance about sexual matters, often best managed by counselling or by a behavioural approach. There are a small number of men with mental retardation and aberrant sexual behaviour who benefit from the prescription of an antilibidinal drug. Treatment with an antilibidinal drug alone reduces the intensity of sexual drive but does not alter its direction; concurrent sexual counselling or psychotherapy is often indicated. The various antilibidinal medications available are reviewed, with particular attention to reports which have described the treatment of people with mental retardation. Of the antilibidinals currently used, medroxyprogesterone acetate and cyproterone acetate are those for which there is most evidence of efficacy. Cyproterone acetate is preferable because it has a specific antiandrogenic action and fewer adverse effects. There is a need for controlled studies of antilibidinal drugs, with clearly defined inclusion criteria and adequate measures of both behavioural and attitudinal change.

L. Laschet

Papers

Results in the treatment of hyper- or abnormal sexuality of men with antiandrogens

Prolonged therapy with human growth hormone