Assessment Methods and Management of Hypersexuality and Paraphilic Disorders

Daniel Turner; Daniel Schöttle; John Bradford; Peer Briken


Curr Opin Psychiatry. 2014;27(6):413-422. 

In This Article

Management of Hypersexuality

Research about treatment interventions and treatment outcomes is scarce, and often lacks generalizability because of deficient methodological study designs, for example, no randomization, missing control groups, and small intervention groups.

For an overview of the treatment methods for hypersexual disorders, one should consider the review conducted by Hook et al..[50] Only one study in the according time period could be identified evaluating the usefulness of high-dose oral medroxyprogesterone acetate (MPA, 100–400 mg daily) for the treatment of inappropriate hypersexual behaviors in 10 men diagnosed with dementia (Mage = 79.5 years).[29] MPA is usually referred to as the third-line agent in the treatment of hypersexual behaviors in individuals with neurodegenerative disorders. Thus, prior to MPA treatment, all men had already received other pharmacological agents [seven men selective serotonin reuptake inhibitors (SSRIs), six men atypical antipsychotics, and one man low-dose MPA]. In seven of the ten patients, healthcare professionals reported significant behavioral improvements leading to the patient's return to his previous living arrangements.[29] Although MPA treatment seems to be an effective alternative for hypersexual patients suffering from dementia or other neurodegenerative disorders, it should however be limited to those resistant to other medications with less side-effects. Severe side-effects accompanied by MPA are, for example, hypertension, hyperglycemia, feminization, weight gain, and especially osteoporosis.[51]