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The Biological Treatment of Paraphilic Disorders: an Updated Review

Current Psychiatry Reports volume 18, Article number: 19 (2016) Cite this article

Abstract

Paraphilic disorders are characterized by atypical sexual interests, fantasies, and behaviors that are subjectively distressing to patients or pose a risk of harm to others. By their very nature, some paraphilic disorders may predispose an individual to commit sexual offenses. The biological treatment of paraphilic disorders, then, is of paramount importance for psychiatry and society at large. Three categories of pharmacologic agents commonly used to treat paraphilic disorders are selective serotonin reuptake inhibitors, synthetic steroidal analogs, and gonadotropin-releasing hormone analogs. Each medication uses a different mechanism of action and has different effects on the physiological and psychological features of paraphilic disorders. In general, these medications have limited high-quality research to support their use. Despite this, some authors have proposed treatment algorithms for individuals with paraphilic disorders of varying severity. These guidelines offer clinicians potentially useful, rational approaches to assessing treatment need in individuals with paraphilic disorders. Recent neuroimaging research suggests that functional magnetic resonance imaging may offer further promise in effectively assessing paraphilic disorders to help direct treatment options.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, 2230 Stockton Blvd., Sacramento, CA, 95817, USA

    Brian J. Holoyda & Denise C. Kellaher

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  1. Brian J. Holoyda
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  2. Denise C. Kellaher
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Correspondence to Brian J. Holoyda.

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This article is part of the Topical Collection on Sexual Disorders

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Holoyda, B.J., Kellaher, D.C. The Biological Treatment of Paraphilic Disorders: an Updated Review. Curr Psychiatry Rep 18, 19 (2016). https://doi.org/10.1007/s11920-015-0649-y

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