The pharmacological treatment of sex offenders

Grubin, D

doi:10.1002/9781118650868.ch27

The pharmacological treatment of sex offenders

Lookup NU author(s): Emeritus Professor Don Grubin

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Abstract

© 2018 John Wiley & Sons, Ltd. All rights reserved. Problematic sexual behavior and sex offending are dependent on sex drive, sexual arousal, and sexual functioning. Although successful treatment requires psychological change, medication that helps an individual to manage their arousal can be an important adjunct to psychological therapies. Serotonergic and dopaminergic neural systems, interacting with testosterone, are fundamental to sexual behavior, and offer prime targets for medical treatment. Selective serotonin reuptake inhibitors (SSRIs) and anti-androgens are the two classes of drug that appear to be most effective in reducing arousal and sexual interest. Medications that reduce testosterone levels and activity are referred to as anti-androgens or anti-libidinals. Indeed, a large meta-analysis of treatment outcome found that while pharmacological treatment had a higher effect size on recidivism than psychological treatments on their own, medical treatment typically also included a cognitive-behavioral component that had an independent treatment effect.