GONADOTROPIN HORMONE-RELEASING HORMONE AGONIST IN CASES OF SEVERE PARAPHILIA - A LIFETIME TREATMENT

Six patients with severe paraphilia were treated with a long-acting go nadotrophin 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 signi ficant side-effects. The beneficial effects of this treatment were mai ntained for 7 years in the patient where there was the longest follow- up. Two patients abruptly withdrew from their antiandrogen treatment a t the end of the first and third year, respectively. Both relapsed wit hin 8-10 weeks. One of them asked for resumption of antiandrogen treat ment. In another case, in order to phase out antiandrogen treatment, t estosterone (T) was added to the GnRH-a. In spite of normal T levels, and of resumption of normal sexual activities and deviant fantasies, d eviant sexual behaviour did not return. A smoother phasing out of GnRH -a treatment is thought to be better than an abrupt withdrawal. Howeve r, the duration of antiandrogen treatment necessary to ensure a comple te disappearance of deviant sexual behaviour remains uncertain, but is at least 4 years. Copyright (C) 1996 Elsevier Science Ltd.