Treatment of Pedophilia with Leuprolide Acetate

Abstract

To date, the literature on the treatment of individuals who have committed sexual offenses has focused primarily on psychotherapeutic interventions and the use of antiandrogens. Recently case reports and small series supporting the efficacy of other psychiatric medication, such as serotonin reuptake inhibitors, have been published. Only a few publications have looked at the efficacy of leuprolide acetate, an LH-RH antagonist, in treatment of sex offenders. Leuprolide acetate has advantages

The Use of Leuprolide Acetate in the Management of High-Risk Sex Offenders

“…Notwithstanding these limitations, results indicated that treatment with LA resulted in a significant suppression of deviant sexual interests and behavior (Krueger & Kaplan, 2001). Similarly, Raymond et al (2001) found, in their case study of a pedophilic sexual offender, that LA treatment was effective in decreasing deviant sexual fantasies, and the patient reported a dramatic reduction in his pedophilic urges. In addition, several review articles with a focus on LA as a treatment for paraphilias and/or sexual offenders have observed that, although there are notable methodological limitations to the current research base in this area, LA appears to offer a viable treatment option with fewer side effects than traditional hormonal agents (Briken, Hill, & Berner, 2003; Briken & Kafka, 2007; Rösler & Witzum, 2000; Saleh & Berlin, 2003).…”

“…This effect can be mitigated or cessation can be achieved through careful monitoring and medical management, including the addition of medications and supplements such as Vitamin D and Calcium (Dickey, 2002; Rösler & Witzum, 1998). There are a few reported case studies supporting the use of LA in sexual offender management (Dickey, 1992; Krueger & Kaplan, 2001; Raymond et al, 2001). Findings from small, uncontrolled studies have found support for the use of LA as a promising adjunct to sex offender treatment (Briken et al, 2001; Schober et al, 2005).…”

“…There is some evidence to suggest that a multidisciplinary approach to treatment, consisting of both medication management and empirically supported CBT approaches, may be the most effective strategy for the management of high-risk sexual offenders. A number of authors have cited the importance of using pharmacological treatments as an adjunct to psychological interventions (Briken & Kafka, 2007; Harrison, 2010; Lösel & Schmucker, 2005; Raymond et al, 2001; Saleh & Berlin, 2003; Schober et al, 2005; Stermac & Hucker, 1988). Namely, professionals working with sexual offenders have reported that sex drive reducing medications have helped limit the influence of deviant sexual thoughts or fantasies.…”

“…Pharmacological approaches to sex offender treatment have received increased interest from both researchers and clinicians in the past two decades. It has been argued that a reduction in sexual drive would subsequently lead to a reduction in deviant sexual behavior (Raymond, Robinson, Kraft, Rittberg, & Coleman, 2001) as well as increase responsiveness to psychotherapy in some offenders (Murray, 2000).…”

Leuprolide Acetate Suppresses Pedophilic Urges and Arousability

“…The specific aspects of behavior that are affected by therapy, as well as the efficacy, limitations, and side effects of treatment need to be determined (Briken et al, 2003;Raymond, Robinson, Kraft, Rittberg, & Coleman, 2001). The present study assessed the impact of cognitive-behavioral psychotherapy alone versus cognitive-behavioral psychotherapy augmented with a potent testosterone-lowering drug, LA, for suppression of pedophilic urges and arousability.…”