In some cases, testosterone-lowering medications may be considered for individuals who have committed sexual offenses in order to reduce their sex drive and the likelihood of them repeating the offense. Pharmacological interventions vary depending on the severity of the offense and the risk of reoffending, but some examples of medications used to reduce sex drive are selective serotonin reuptake inhibitors (SSRIs), cyproterone acetate (CPA), and gonadotropin-releasing-hormone (GnRH)-agonists. For very severe cases, GnRH-agonists may be used in combination with CPA.

This treatment approach has been hotly debated in the field of sexual medicine. While it may help to protect the greater community by minimizing the risk of a repeated sexual offense, testosterone-lowering medications can have negative side effects for the patient. As such, not all outpatient treatment centers for people who have committed sexual offenses prescribe this type of treatment.

The authors of a recent study sent an online survey to 103 outpatient clinics for individuals who have committed sexual offenses in Germany. Thirty-three clinics responded with the completed survey, which detailed the prescription patterns and the adherence to treatment (or lack thereof) of 834 patients.

They found that 187 of the 834 patients (22.4%) were treated with medications intended to reduce their sex drive. Of the patients treated with medication, 75 (40.1%) were prescribed GnRH-agonists, 49 (26.2%) antipsychotics, 46 (24.6%) SSRIs, 12 (6.4%) CPA, and 5 (2.7%) GnRH-agonists and CPA. There was a significant association between the number of patients who had been in a forensic-psychiatric hospital and the number who were treated with testosterone-lowering medication.

Nevertheless, some of the patients discontinued their medication during the supervision period when the study took place. A total of 16 patients (8.6%) stopped their medication while under parole or at the end of their supervision period. Eight (50%) of the patients who discontinued their medication did so without their providers’ consent, 5 (31.3%) stopped due to side effects, and 3 (18.8%) requested to stop taking their medication with their providers’ consent.

These findings are important because they indicate that patients may be likely to stop taking their testosterone-lowering medication, especially once their supervision period has ended. This may be a consideration for future pharmacological treatment plans aimed at reducing the sex drive of individuals.

References:

• Sauter, J., Rettenberger, M., Briken, P., & Turner, D. (2022). Survey on the Prescription Patterns of Pharmacological Agents in Individuals Who Have Committed Sexual Offenses During Forensic Outpatient Treatment in Germany: How Many Discontinue Testosterone Lowering Medication Under Parole?. The Journal of Sexual Medicine, 19(7), 1147-1155. DOI: https://doi.org/10.1016/j.jsxm.2022.04.005