Medroxyprogesterone acetate, nocturnal penile tumescence, laboratory arousal, and sexual acting out in a male with schizophrenia

Abstract

This study reports the effects of the antilibidinal drug, medroxyprogesterone acetate (MPA) on nocturnal penile tumescence (NPT) during sleep, tumescence responses to provocative audiotapes during wakefulness in the laboratory, and sexual behaviors in the hospital environment, in a conduct-disordered sexually aggressive male, who had not responded to previous treatment. NPT, laboratory tumescence, and sexual behaviors in the hospital environment were all decreased. Testosterone levels declined by 73% within 2 weeks of starting the drug and prolactin levels increased by 300% across the treatment period. The effects on NPT and laboratory arousal were still partially in evidence 2 months after the drug had been stopped, although testosterone levels had returned to predrug levels. Some differences between the NPT and daytime test data are discussed in terms of the probable importance of testosterone to erotic fantasy. NPT may be a useful addition to present methods for examining the effects of drugs used to suppress socially unacceptable sexual behaviors.

Pharmacological management of inappropriate sexual behaviours: a review of its evidence, rationale and scope in relation to men with intellectual disabilities

“…All the three patients showed marked improvement in their ISBs but relapsed on discontinuation or reduction in dose of MPA (Ross et al. 1987; Cooper et al. 1990; Myers 1991).…”

“…However, apart from the three case reports summarised in Table 2, we could not find any other trials that explicitly included people with ID. All the three patients showed marked improvement in their ISBs but relapsed on discontinuation or reduction in dose of MPA (Ross et al 1987;Cooper et al 1990;Myers 1991).…”