Skip to main content

Advertisement

Log in

Double-blind placebo crossover study of cyproterone acetate in the treatment of the paraphilias

  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Cyproterone acetate is a powerful antiandrogen used in the treatment of the paraphilias for at least a decade. Studies have reported it effective in reducing the recidivism rates of sexual crimes perpetrated by men. It acts through competitive inhibition of the androgen receptors blocking the effects of testosterone and dihydrotestosterone. Systematic clinical study of its effectiveness and its clinical effects on sexual behavior is lacking, however. In the current study 19 paraphilic men who had also recidivated in a variety of sexual crimes were treated with cyproterone acetate and placebo in a double-blind crossover design. The use of active drug was associated with a significant reduction of some aspects of sexual behavior, particularly sexual fantasies. There were also significant effects on levels of circulating sex hormones and some effects on physiological measurements and self-reports of sexual arousal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abel, G. G., Becker, J. V., and Skinner, L. J. (1980). Aggressive behaviour and sex.Psychiat. Clin. N. Am. 3: 133.

    Google Scholar 

  • Abel, G. G., Becker, J. V., and Skinner, L. J. (1983). Treatment of the violent sex offender. In Roth, L. H. (ed.),Clinical Treatment of the Violent Person. Crime and Delinquency Issues, National Institute of Mental Health Monograph Series, Bethesda, MD.

    Google Scholar 

  • Abel, G. G., Mittelman, M. S., and Becker, J. V. (1984). Sexual offenders: Results of assessments and recommendations for treatment. In Ben-Aron, M. H., Hucker, S. J., and Webster, C. D. (eds..),Clinical Criminology: The Assessment and Treatment of Criminal Behaviour M & M Graphics, Toronto.

    Google Scholar 

  • American Psychiatric Association. (1987).Diagnostic and Statistical Manual of Mental Disorders 3rd. ed., rev., APA, Washington, DC, pp. 261–285.

    Google Scholar 

  • Appelt, M., and Floru, L. (1974). Erfahrungen uber die Beeinflussung der Sexualitat durch Cyproteronacetat (“Androcur,” Schering).Int. Pharmacopsychiat. 9:61.

    Google Scholar 

  • Bancroft, J. (1983).Human Sexuality and Its Problems Churchill Livingstone, New York, pp. 145–152.

    Google Scholar 

  • Bancroft, J. (1988). Reproductive hormones and male sexual function. In Sitsen, J. M. A. (ed.),The Pharmacology and Endocrinology of Sexual Function, Handbook of Sexology, Vol. 6, Elsevier, Amsterdam, pp. 297–316.

    Google Scholar 

  • Bancroft, J. (1989).Human Sexuality and Its Problems 2nd ed., Churchill Livingstone, New York. pp 12–146.

    Google Scholar 

  • Bancroft, J., Tennent, T. G., Loucas, K., and Cass, J. (1974). Control of deviant sexual behaviours of drugs: Behavioural changes following oestrogens and antiandrogens.Br. J. Psychiat. 125: 310.

    Google Scholar 

  • Baron, D. P., and Unger, H. R. (1977). A clinical trial of Cyproterone acetate for sexual deviancy.New Engl. J. Med. 85: 366.

    Google Scholar 

  • Berner, W., Brownstone, G., and Sluga, W. (1983). The Cyproteronacetat treatment of sexual offenders.Neurosci. Biobehav. Rev. 7: 441.

    PubMed  Google Scholar 

  • Bradford, J. M. W. (1979)Forensic Psychiatric Questionnaire. Unpublished Document; copyright J. Bradford.

  • Bradford, J. M. W. (1983a). Research on sex offenders: Recent trends.Psychiat. Clin. N. Am. 6: 715–731.

    Google Scholar 

  • Bradford, J. M. W. (1983b). Hormonal treatment of sexual offenders.Bull. Am. Acad. Psychiat. Law 11: 159–169.

    Google Scholar 

  • Bradford, J. M. W. (1984). The psychiatric evaluation of the sexual offender.Newsletter, Am. Acad. Psychiat. Law 9: 18–19.

    Google Scholar 

  • Bradford, J. M. W. (1985). Organic treatments for the male sexual offender.Behav. Sci. Law 3: 355–375.

    Google Scholar 

  • Bradford, J. M. W. (1988). Treatment of sexual offenders with cyproterone acetate. In Sitsen, J. M. A. (ed.),Handbook of Sexology: The Pharmacology and Endocrinology of Sexual Function, Vol. 6, Elsevier, Amsterdam, pp. 526–536.

    Google Scholar 

  • Bradford, J. M. W., and Pawlak, A. (1987). Sadistic homosexual pedophilia: Treatment with cyproterone acetate: A single case study.Can J. Psychiat. 32: 22–30.

    Google Scholar 

  • Buss, A. H., and Durkee, A. (1957). An inventory for assessing different kinds of hostility.J. Consult. Psychol. 21: 343–349.

    PubMed  Google Scholar 

  • Cooper, A. J. (1981). A placebo controlled trial of the antiandrogen cyproterone acetate in deviant hypersexuality.Comprehen. Psychiat. 22: 458.

    Google Scholar 

  • Cooper, A. J., Ismail, A. A., Phanjoo, A. L., and Love, D. L. (1972). Antiandrogen (cyproterone acetate) therapy in deviant hypersexuality.B. J. Psychiat. 120: 59.

    Google Scholar 

  • Davies, T. S. (1974). Cyproterone acetate for male hypersexuality.J. Int. Med. Res. 2: 159.

    PubMed  Google Scholar 

  • Fahndrich, E. (1974). Cyproteronacetat in der Behandlung von Sexual deviationen, bei Mannern.Deut. Med. Wochschr. 99: 234.

    Google Scholar 

  • Freund, K. (1980). Therapeutic sex drive reduction.Acta Psychiat. Scand. 62: 5–38.

    Google Scholar 

  • Gebhard, P. H., Gagnon, J. H., Pomeroy, W. B., and Christenson, C. V. (1965).Sex Offenders: An Analysis of Types Harper and Row, New York, pp. 811–812.

    Google Scholar 

  • Halleck, S. L. (1981). The ethics of antiandrogen therapy.Am. J. Psychiat. 138: 642–643.

    PubMed  Google Scholar 

  • Horn, J. H. (1972). Die Behandlung von Sexual Delinquenten mit Cyproteronacetat.Life Sci. Monogr. 2: 113.

    Google Scholar 

  • Jost, F. (1974). Klinische Beobachtungen und Erfahrungen in der Behandlung Sexueller Deviationen mit dem Antiandrogen Cyproterone-Acetat.Schweiz. Rundschau. Med. (Praxis) 63: 1318.

    Google Scholar 

  • Jost, F. (1975). Zur Behandlung Abnormen Sexualverhaltens mit dem Antiandrogen Cyproteronacetat, Der Informierte.ARZT 3: 303.

    Google Scholar 

  • Laschet, U. (1973). Antiandrogen in the treatment of sexual offenders: Mode of action and therapeutic outcome. In Zubin, J., and Money, J. (eds.),Contemporary Sexual Behaviours: Critical Issues in the 1970's Johns Hopkins Press, Baltimore, MD, p. 311.

    Google Scholar 

  • Laschet, U., and Laschet, L. (1971). Psychopharmacotherapy of sex offenders with cyproterone acetate.Pharmakopsychiat. Neuropsychopharmakol. Adv. Clin. Res. 4: 99.

    Google Scholar 

  • Laschet, U., and Laschet, L. (1975). Antiandrogens in the treatment of sexual deviations of men.J. Steroid Biochem. 6: 821.

    PubMed  Google Scholar 

  • Minister of Supply and Services Canada. (1984). Report of the Committee on Sexual Offences Against Children and Youths: Sexual Offences Against Children in Canada, Vol. I, II, and Summary.

  • Mothes, C., Lehnert, J., Samimi, F., and Ufer, J. (1971). Schering Symposium Uber Sexual Deviationen und Ihre Medikamentose Behandlung, Pergamon, Oxford.

    Google Scholar 

  • Murray, M. A., Bancroft, J., Anderson, D. C., Tennent, T. G., and Carr, R. J. (1975). Endocrine changes in male sexual deviants after treatment with antiandrogens, oestrogens, or tranquilizers.J. Endocrinol. 67: 179.

    PubMed  Google Scholar 

  • Neumann, F., Graf, K. J., Hasam, S. H., Schewck, B., and Steinbeck, H. (1977). Central actions of antiandrogens. In Martini, L., and Motta, M. (eds.),Androgens and Antiandrogens Raven, New York, pp. 163–177.

    Google Scholar 

  • Neumann, F., and Schleusener, A. (1980). Pharmacology of cyproterone acetate with special reference to the skin. In Vokoer, R., and Fanta, D. (Eds.),The Pharmacology of Cyproterone Acetate, Combined Antiandrogen-Estrogen Therapy in Dermatology, Proceedings of Dianne Symposium, Brussels, pp. 19–51.

  • Neumann, F., and Von Berswordt-Wallrabe, R. (1966). Effects of the of the androgen antagonist cyproterone acetate on the testicular structure: Spermiogenesis and accessory sexual glands of testosterone treated hypophysectomized rats.J. Endocrinol. 35: 363–367.

    PubMed  Google Scholar 

  • Neumann, F., Von Berswordt-Wallrabe, R., Eiger, W., Steinbeck, H., Hahn, J. D., and Kramer, M. (1970). Aspects on androgen dependent events as studied by antiandrogens.Recent Prog. Horm. Res. 26: 227–342.

    Google Scholar 

  • Ortman, J. (1980). The treatment of sexual offenders: Castration and antihormone therapy.Int. J. Law Psychiat. 3: 443–451.

    Google Scholar 

  • Ott, F., and Hoffet, H. (1968). The influence of antiandrogens on libido, potency and testicular function.Schweiz. Med. Wochschr. 98: 1812.

    Google Scholar 

  • Overall, J. E., and Gorham, D. R. (1962). The Brief Psychiatric Rating Scale.Psychol. Rep. 10: 799–812.

    Google Scholar 

  • Rand, M. J., and Nott, M. W. (1988). Basic neuropharmacology in sexology. In Sitsen, J. M. A. (ed.),The Pharmacology and Endocrinology of Sexual Function, Vol. 6, Elsevier, Amsterdam, 1–32.

    Google Scholar 

  • Radzinowicz, L. (1957).Sexual Offences: A Report of the Cambridge Department of Criminal Science MacMillan, London, pp. 156–157.

    Google Scholar 

  • Rausch-Stroomann, J. G., Petry, R., Hocevar, V., Mauss, J., and Senge, T. (1970). Influence of an antiandrogen (cyproterone) on the gonadotrophic function of the pituitary gland on the gonads, and on metabolism in normal men.Acta Endocrinol. 63: 595–608.

    PubMed  Google Scholar 

  • Schering, A. G. (1983).Androcur Berlin/Bergkamen, Berlin, Germany.

    Google Scholar 

  • Soothill, K. L., and Gibbens, T. C. N. (1978). Recidivism of sexual offenders: Reappraisal.Br. J. Criminol. 18: 267–275.

    Google Scholar 

  • Statistics Canada. (1982).Uniform Crime Reporting Statistics Canada and the Provinces 1977–1981, Sexual Offences. Canadian Centre for Justice Statistics, Ottawa.

    Google Scholar 

  • Tennent, G., Bancroft, J., and Cass, J. (1974). The control of deviant sexual behavior by drugs: A double-blind controlled study of benperidor, chrorpromatine and placebo.Arch. of Sex. Behav. 3: 261–271.

    Google Scholar 

  • Woodbury, J., and Schwart, E. (1971).The Silent Sin New American Library, New York.

    Google Scholar 

  • Zbytovsky, J., and Zapletalek, M. (1979). Cyproteroneacetate in the therapy of sexual deviations.Activatis Nervosa Super. (Praha) 21: 162.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bradford, J.M.W., Pawlak, A. Double-blind placebo crossover study of cyproterone acetate in the treatment of the paraphilias. Arch Sex Behav 22, 383–402 (1993). https://doi.org/10.1007/BF01542555

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01542555

Key words

Navigation