Protocols for the Use of Cyproterone, Medroxyprogesterone, and Leuprolide in the Treatment of Paraphilia

Reilly, Dan R; Delva, Nicholas J.; Hudson, Robert

doi:10.1177/070674370004500608

Cited by 36 publications

(30 citation statements)

References 24 publications

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“…This is a chlorinated derivate of progesterone with antiandrogen and progesterone-like activities. Cyproterone acetate alone or in combination with estrogens has been shown to be effi cient in a variety of conditions, including prostate or breast cancer [3], hirsutism [4], acne [5] and hypersexual behavior disorders [6]. Adverse effects of cyproterone acetate have included impotence, headache, menstrual irregularities, gynecomastia and hepatotoxicity [7].…”

Section: Introductionmentioning

confidence: 99%

Hepatotoxicity Induced by Antiandrogens: A Review of the Literature

Thole

Manso²,

Salgueiro³

et al. 2004

Urol Int

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Introduction: Hepatotoxicity is a serious adverse reaction potentially induced by all antiandrogens. We have reviewed here the published cases of hepatotoxicity induced by steroidal and nonsteroidal antiandrogens, and compared the type and characteristics of liver damage. Methods: Using two different databases: MEDLINE and IDIS (Iowa Drug Information Service), we searched for published cases of liver injury induced by antiandrogens. Analysis was made of the type of hepatotoxicity, therapeutic indication, other pharmacological treatments and evolution. Mean values of latency and recovery periods of the adverse reactions and liver function tests were also evaluated. Results: Hepatitis was the most common type of hepatotoxicity reported, and was associated with all antiandrogens. This adverse reaction does not seem to be dependent on the patients age, therapeutic indication or the dose prescribed. Hepatitis showed a longer latency period for cyproterone acetate than for flutamide. Some transaminase levels were significantly higher for flutamide than for cyproterone acetate, although the evolution was no worse in the cases reported for flutamide. We also found occasional reports of hepatocellular carcinoma and hepatic cirrhosis suspected of being induced by cyproterone acetate. Conclusion: Although there are differences in the clinical features of hepatotoxicity induced by steroidal and nonsteroidal antiandrogens, these do not predict which patients will develop hepatotoxicity during treatment or evolution. Serial liver function tests are required for early detection of liver damage.

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Section: Introductionmentioning

confidence: 99%

Hepatotoxicity Induced by Antiandrogens: A Review of the Literature

Thole

Manso²,

Salgueiro³

et al. 2004

Urol Int

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“…In this case study, 10 kg/6 months weight gain and appetite increasing were observed due to the side effect of the drug, but there was no other particular side effect complaint. In the first 2-4 days after the administration of GnRH depot agents, special attention is required because sexual drive could increase (19). This is because GnRH analogues temporarily increase progesterone and follicle-stimulating hormone in the initial stage.…”

Section: Discussionmentioning

confidence: 99%

A Case of Mental Retardation with Paraphilia Treated with Depot Leuprorelin

et al. 2014

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Paraphilia is a psychiatric disease that has been difficult to cure. However, recently developed therapeutic methods hold promise. The patient was a 20-yr-old male with chief complaints of continuous masturbation, genital exposure, and aggressive behavior that started 2 yr ago. We administered leuprorelin 3.6 mg intramuscular injection per month, a depot gonadotrophin-releasing hormone analogue, to this patient who a severe mentally retardation with paraphilia. The clinical global impression (CGI)-severity, CGI-improvement and aberrant behavior checklist were performed. After one month, we observed significant improvement in symptoms, such as decreases of abnormal sexual behavior and sexual desire. The GnRH analogues are suggested to be used as an alternative or supplementary therapeutic method for sexual offenders after clinical studies.Graphical Abstract

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“…Besondere Bedeutung kommt der möglichen Karzinogenität und Hepatotoxizität zu. Nachdem Neumann et al [26] festgestellt hatten, dass CPA DNA-Schäden an kultivierten Leberzellen von Ratten hervorruft und 1991 von einigen Fällen tödlich verlaufender Leberschädigung in der CPA-Behandlung von Patienten mit Prostatakarzinom berichtet wurde (nach Reilly [27]), wurde eine groûe Studie zur Sicherheit von CPA initiiert [21]. In dieser unkontrollierten ¹Follow-up-Studieª wurden 2506 Patienten mit besonderem Augenmerk auf Entwicklung von Leberzellkarzinomen und Hepatotoxizität untersucht.…”

Section: Pharmakologische Interventionsmöglichkeitenunclassified

“…Daher sollten die Patienten darüber informiert sein, dass eventuell ein Risiko des Verlustes der Fertilität und sexuellen Aktivität besteht [27]. Die meisten Autoren gehen von der Reversibilität der Beeinträchtigung der Sexualfunktionen aus [6,15,20,22].…”

Section: Pharmakologische Interventionsmöglichkeitenunclassified

Medikamente in der Behandlung von Paraphilien und hypersexuellen StÃ¶rungen

Hebebrand¹,

Remschmidt²

2002

Fortschr Neurol Psychiatr

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We review the indications, modes of action, effectiveness, side effects, legal and ethical aspects of pharmacological agents which reduce sexual desire. It needs to be emphasized that these agents - regardless of their indication - should never be used without concomitant psychotherapy. Nevertheless, in this review we focus on pharmacotherapy, because it can be an important part of the therapeutic procedure and appropriate knowledge is required. A part of the review pertains to the therapy of male adolescents.

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Protocols for the Use of Cyproterone, Medroxyprogesterone, and Leuprolide in the Treatment of Paraphilia

Cited by 36 publications

References 24 publications

Hepatotoxicity Induced by Antiandrogens: A Review of the Literature

Hepatotoxicity Induced by Antiandrogens: A Review of the Literature

A Case of Mental Retardation with Paraphilia Treated with Depot Leuprorelin

Medikamente in der Behandlung von Paraphilien und hypersexuellen StÃ¶rungen

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