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

Abstract

The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care. Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews. Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behavior endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders. Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.

Transdermal estradiol as a novel treatment for Peyronie's disease: A case report

“…Transdermal estradiol, which does not have the cardiovascular side effects of oral estradiol, presents a novel off-label treatment for both PD and paraphilias. There is no published study to our knowledge that uses transdermal estradiol in PD, although studies testing its application in men with prostate cancer have successfully lowered PSA levels and have not elicited significant side effects other than gynecomastia (15,16).…”

Minor-attracted persons: A neglected population

“…Testosterone-lowering medications such as gonadotropin-releasing hormone (GnRH) analogue treatment constitutes the most effective treatment for patients who are not helped by conventional psychotherapeutic interventions. 17 Other psychotropic medications, such as selective serotonin reuptake inhibitors or naltrexone, have not demonstrated efficacy outside of case reports. 17…”

Особенности Полового Самосознания У Больных Шизофренией С Множественными Расстройствами Сексуального Предпочтения

“…Критерием исключения из исследования было обострение шизофрении в связи с невозможностью участия в исследовании по психическому состоянию. Все пациенты в период исследования находились на антипсихотической терапии (галоперидол, хлорпромазин, хлорпротиксен, трифлу-операзин, кветиапин, рисперидон, клозапин, диазепам, хлордиазепокид) в соответствии с клиническими показаниями в сочетании с антиандрогенной терапией (ципротерон ацетат пролонгированного действия для инъекций, средняя доза составила 300 мг 1 раз в 2 недели в/м) и психотерапией [4,5,21].…”