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Journal ArticleDOI

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

01 Aug 1970-Journal of Sex Research (Taylor & Francis Group)-Vol. 6, Iss: 3, pp 165-172
TL;DR: This work has shown that in women the drug has an antiovulatory effect, and when a bisexual transvestite patient under long-term followup study underwent a crisis of pedophilia, fellatio and incest with his six year old son, the decision to try therapy with Depo-Provera?
Abstract: 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.
Citations
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Journal ArticleDOI
TL;DR: The influence of endocrine, neurotransmitter, and central nervous system influences on male and female sexual function are discussed for sexual desire, arousal, and orgasm or ejaculation stages of sexual responding.
Abstract: This article provides a review of the past and current literature on the neurobiology of sexual function. The influence of endocrine, neurotransmitter, and central nervous system influences on male and female sexual function are discussed for sexual desire, arousal, and orgasm or ejaculation stages of sexual responding. Endocrine factors reviewed include the following: androgens, estrogens, progesterone, prolactin, oxytocin, cortisol, and pheromones. Neurotransmitters and neuropeptides discussed include nitric oxide, serotonin, dopamine, epinephrine, norepinephrine, opioids, acetylcholine, histamine, and γ-aminobutyric acid. Central nervous system influences on sexual function are discussed briefly with reference to brainstem regions, the hypothalamus, and the forebrain.

431 citations

Journal ArticleDOI
TL;DR: In this article, the authors concluded that comprehensive cognitive/behavioral programs (at least for child molesters, incest offenders, and exhibitionists) are most likely to be effective, although there is a clear value for the adjunctive use of antiandrogens with those offenders who engage in excessively high rates of sexual activities.

274 citations

Journal ArticleDOI
TL;DR: Sublingual medroxyprogesterone acetate therapy is useful in the management of the Pickwickian syndrome and causes improvement in both the oxygen and carbon dioxide tensions.
Abstract: Ten patients with the Pickwickian syndrome, characterized by obesity, hypoxemia, hypercapnia, polycythemia, and cor pulmonale, underwent long-term treatment as outpatients with medroxyprogesterone acetate. Although there was no significant weight change in the group, PaO2 rose 12.6 +/- 2.7 mm Hg (SEM) from 49 +/- 2.6 mm Hg to 62 +/- 2.3 mm Hg (P less than 0.001), while PaCO2 fell 13 +/- 2.6 mm Hg from 51 +/- 1.9 mm Hg to 38 +/- 1.2 mm Hg (P less than 0.001). Hematocrit fell from 56 +/- 2.5% to 50 +/- 1.2%, a mean fall of 6% (P less than 0.01), during medroxyprogesterone acetate therapy. In the 2 patients who had cardiac catheterization before and during medroxyprogesterone acetate therapy, mean pulmonary arterial pressure fell 13 and 19 mm Hg. There were no recurrences of cor pulmonale during treatment. These effects on arterial blood gas values and clinical state were sustained during therapy. On withdrawal of medroxyprogesterone acetate during 1-month period, arterial oxygen and carbon dioxide tensions deteriorated to their previous pretreatment values. Reinstitution of medroxyprogesterone acetate caused improvement in both the oxygen and carbon dioxide tensions. We conclude that sublingual medroxyprogesterone acetate therapy is useful in the management of the Pickwickian syndrome.

212 citations

Journal ArticleDOI
TL;DR: Sexual deviation disorders, or paraphilias, are diagnosable psychiatric syndromes manifested by recurrent fantasies about deviant sex, intense associated cravings, and stereotypic behavioral responses.
Abstract: Sexual deviation disorders, or paraphilias, are diagnosable psychiatric syndromes manifested by 1) recurrent fantasies about deviant sex, 2) intense associated cravings, and 3) stereotypic behavioral responses. Pedophiles seek out children in response to their erotic thoughts and urges, whereas exhibitionists expose themselves. Paraphiliac syndromes ordinarily follow a chronic course and may be associated with biological pathology, but etiological factors are poorly understood. Treatment becomes a consideration when the well-being or rights of others are compromised. Proposed treatments have included psychotherapy, behavior therapy, surgery, and medication. Medroxyprogesterone acetate, which reduces testosterone, may diminish sexual preoccupation and urges, making self-control easier.

210 citations

Journal ArticleDOI
TL;DR: The use of medroxyprogesterone in treating sexual deviants has recently been reported and it was found not only to be effective in controlling behaviour but also to produce marked reduction in circulating androgen.
Abstract: The effects of cyproterone acetate and ethinyl oestradiol on sexual behaviour of sexual offenders was assessed using a combination of behavioural, attitudinal and physiological measures. There was no significant difference between the drugs on any measure. They were equally effective in reducing frequency of sexual thoughts and sexual activity, whereas only cyproterone acetate produced a weak effect in reducing erectile and subjective responses to erotic stimuli. The possibility of a placebo effect cannot be excluded. On the dosages used, neither drug produced troublesome side effects. Further work is needed to assess the effects of longer administration and varying dose levels.

178 citations

References
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Book ChapterDOI
01 Jan 1968
TL;DR: In der folgenden Zeit weiter von diesen Autoren untermauert, wiesen einen neuen Weg zur Behandlung der pathologisch gesteigerten oder abartigen Sexualitat des Mannes as discussed by the authors.
Abstract: Untersuchungsergebnisse von Neumann und Elger, vorgetragen beim Androgensymposion in Gent im Juni 1965, in der folgenden Zeit weiter von diesen Autoren untermauert, wiesen einen neuen Weg zur Behandlung der pathologisch gesteigerten oder abartigen Sexualitat des Mannes.

6 citations