Cyproterone acetate therapy and aggression

Abstract

CORRESPONDENCE age = 41 .6 (10. 1) years), and eight men (mean (s.d.) age = 46.3 (9.4) years). Three women were divorced and the other eight married, contrasting with twoSCHMIDT, C., KLEE,L. & AMES.G. (1990) Review and analysis of literatures on indicators of women's drinking problems. British JournalofAddiction. 85, 179-192.married men, one separated man and four single, i.e.never married, men, among the seven for whom thisdata was recorded.The mean (s.d.) age of the onset of drinking was21 .8 (7.6) years for the women compared with 17.8(2.7) years in the men. Men had drunk for 26.7(10.2)years before seeking treatment compared with 18.0(7.2) years in women. Of the women, eight hadsuffered from medical complications, compared with only three ofthe men. Women were more likely to drink at home on their own than men (8 1.8% compared with 42.9%). While numbers in our sample were too small to allow a statistical analysis, these results agree with earlier studies (e.g. Leyland, 1982; Schmidt et a!, 1990) in suggesting that women present to psychi atric servicesat a similar age to men but with a shorter history of drinking. They are more prone toCyproterone acetate therapy and aggression SIR: The recent correspondence from Thibaut et a!

Treatment of Inappropriate Sexual Behavior in Dementia

“…Cyproterone acetate (CPA) inhibits the interaction between endogenous androgens and androgen receptors, as well as reducing the biosynthesis of androgens. Effective treatment of ISB with CPA 50 mg was reported in a 60-year-old man with AIDS-related dementia [ 87 ]; however, another case report described unsuccessful CPA treatment in a 70-year-old with dementia, with additional numerous adverse effects impacting on mobility [ 88 ]. CPA 10 mg was used with beneficial effect in two males with dementia-related ISB that had not responded to treatment with antipsychotic or sedative medication.…”

The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders

“…In some cases, PPG was used. In most cases, paraphilic sexual behavior disappeared within 2 weeks except for one case; in this latter case, CPA was withdrawn after 2 weeks due to side effects (Byrne et al, 1992). Cooper et al (1992a) reported a better efficacy with 200 mg/day of CPA as compared with 100 mg/day.…”

“…• Case reports Twenty-one patients were reported in 11 case reports (Cooper et al, 1972;Lederer, 1974;Bradford and Pawlack 1987;Grinshpoon et al, 1991;Thibaut et al, 1991 andByrne et al, 1992;Cooper et al, 1992a;Eriksson and Eriksson 1998;Gooren et al, 2001;Panesar et al, 2011, no information available;Amelung et al, 2012 no information provided on the type of antiandrogen therapy in 6 pedophiles). Two pedophilic subjects with mild to moderate mental retardation, one exhibitionist, other non-specified sex offenders (aged from 23 to 70 years, in 2 cases dementia was associated with sexual disinhibition) were receiving CPA (50 to 200 mg/day or 275 to 300 mg i.m.…”

“…✓ Side effects related to hypoandrogenism: Erectile dysfunction, hot flushes, pilosity changes, hair loss, decreased sebum excretion rate, spermatogenesis reduction (reversible), impotence, decrease of sexual activity and fantasies, reduced ejaculate volume, asthenia (in 1 case, treatment was stopped at week 2; Byrne et al 1992), sleep disorders, depressive symptoms or disorders (Cooper et al, 1992a andb), leg cramps, andosteoporosis (Gis andGooren, 1996;Grasswick and Bradford, 2003) were reported. One hip fracture due to the bone mineral loss was observed in a 52-year-old man after 10 years of CPA treatment (300 mg/2 weeks) (Gooren et al, 2001).…”