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

Abstract

The quality of evidence base for the use of pharmacological agents in the treatment of ISBs is inadequate to justify their use in routine clinical practice. If used, they should only be a part of a comprehensive treatment programme and closely monitored. In addition, there are several clinical, ethical and legal issues to be addressed before considering pharmacological treatment of ISBs in people with ID.

Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base

“…); pharmacological treatment of bipolar disorder in children and adolescents (Gutkovich & Carlson ); pharmacological management of inappropriate sexual behaviours (Sajith et al . ); and somatic treatment of psychiatric and behavioural problems, including psychotropic medication and electroconvulsive therapy (Ulzen & Powers ). These reviews are summarized in Table Section I.…”

“…These include three Cochrane reviews: pharmacological interventions for self-injurious behaviour (Rana et al 2013) donepezil for Alzheimer's dementia (AD) in people with Down's syndrome (Mohan et al 2009d); and amphetamine for attention-deficit hyperactivity disorder (ADHD) (Thomson et al 2009a). Other reviews considered the following: atypical antipsychotics for behavioural problems in children with intellectual disability or borderline intelligence (Unwin & Deb 2011); clozapine for behavioural problems (Singh et al 2010); melatonin for sleep problems (Braam et al 2009); mood stabilizers and anti-epileptic medication for behavioural problems in adults (Deb et al 2008); pharmacological treatment of bipolar disorder in children and adolescents (Gutkovich & Carlson 2008); pharmacological management of inappropriate sexual behaviours (Sajith et al 2008); and somatic treatment of psychiatric and behavioural problems, including psychotropic medication and electroconvulsive therapy (Ulzen & Powers 2008). These reviews are summarized in Table 2 Section I.…”

Sex offenders with intellectual disabilities and their academic observers: popular methodologies and research interests

“…One article discussed pharmacological management (Sajith et al . ) and referred to another that explored surgical castration (Weinberger et al . ).…”

Conditionally Sexual: Men and Teenage Boys with Moderate to Profound Intellectual Disability

“…In a review of the research literature we found that sexual matters for men and boys with intellectual disability were often framed by a focus on socio-sexual pathologies such as criminal/anti-social behaviour and problematic sexual behaviour [20]. We have termed this a ''problematised'' male discourse that is underpinned by factors such as a reported disproportionate rate of sexually inappropriate behaviour [21,22], inappropriate masturbation [10,23], use of anti-libidinal medication [24,25], and inappropriate touch of female care staff [26]. Absent within this discourse are studies that focus on the right to sexual expression for enjoyment and strategies to facilitate the development of a healthy masculine sexuality.…”