DOUBLE-BLIND PLACEBO CROSSOVER STUDY OF CYPROTERONE-ACETATE IN THE TREATMENT OF THE PARAPHILIAS

Cyproterone acetate is a powerful antiandrogen used in the treatment o f the paraphilias for at least a decade. Studies have reported it effe ctive in reducing the recidivism rates of sexual crimes perpetrated by men. It acts through competitive inhibition of the androgen receptors blocking the effects of testosterone and dihydrotestosterone. Systema tic clinical study of its effectiveness and its clinical effects on se xual behavior is lacking, however. In the current study 19 paraphilic men who had also recidivated in a variety of sexual crimes were treate d with cyproterone acetate and placebo in a double-blind crossover des ign. The use of active drug was associated with a significant reductio n of some aspects of sexual behavior, particularly sexual fantasies. T here were also significant effects on levels of circulating sex hormon es and some effects on physiological measurements and self-reports of sexual arousal.