Paraphilias Medication

  • Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD   more...
 
Updated: Oct 28, 2010
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Antidepressants

Class Summary

May be used to decrease aggression and treat underlying illness.

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Fluoxetine (Prozac)

 

Antidepressant (SSRI) used to treat impulse control problems or underlying illness. Selectively inhibits presynaptic serotonin reuptake with minimal or no effect in the reuptake of norepinephrine or dopamine.

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Lithium (Eskalith)

 

Indicated for treating bipolar disorder. Influences reuptake of serotonin and/or norepinephrine at cell membrane.

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Mirtazapine (Remeron)

 

Exhibits both noradrenergic and serotonergic activity. In cases of depression associated with severe insomnia and anxiety, shown to be superior to other SSRI drugs.

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Antiandrogens

Class Summary

Used to reduce androgen serum levels.

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Medroxyprogesterone (Depo-Provera)

 

Derivative of progesterone. Used for breast cancer, contraception, secondary amenorrhea, and abnormal uterine bleeding. May be used to reduce sex drive.

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Phenothiazines

Class Summary

Are effective in treating emesis possibly due to their effects in the dopaminergic mesolimbic system.

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Fluphenazine (Prolixin)

 

Antipsychotic used to treat underlying illness or decrease aggression.

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Anxiolytics

Class Summary

These agents help induce impulse control.

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Buspirone (BuSpar)

 

Unique anxiolytic that differs from benzodiazepines in that it does not exert anticonvulsant or muscle relaxer for GAD. A 5-HT1 agonist with serotonergic neurotransmission and some dopaminergic effects in CNS. Has anxiolytic effect but may take as long as 2-3 wk for full efficacy.

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Long-acting gonadotropin-releasing hormones

Class Summary

These agents are used to reduce release of gonadotropin hormones.

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Triptorelin (Trelstar)

 

Synthetic decapeptide agonist analog of GnRH also known as luteinizing hormone–releasing hormone (LHRH). Reduces LH, FSH, and testosterone, which may lead to reduced sex drive.

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Mood stabilizer

Class Summary

These agents are used to treat bipolar disorders.

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Valproic acid (Depakote)

 

Indicated for manic episodes associated with bipolar disorder. Recommended plasma concentration is 50-125 µg/mL.

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Contributor Information and Disclosures
Author

Guy E Brannon, MD  Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company

Guy E Brannon, MD is a member of the following medical societies: American Medical Association, American Medical Writers Association, American Psychiatric Association, American Society of Addiction Medicine, Association of Clinical Research Professionals, Louisiana State Medical Society, and Southern Medical Association

Disclosure: AstraZeneca Grant/research funds Other; Janssen Grant/research funds Other; Pfizer Honoraria Speaking and teaching; Sunovion Honoraria Speaking and teaching; Eli Lilly Grant/research funds Other; Forrest Grant/research funds Other

Specialty Editor Board

Mohammed A Memon, MD  Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD  Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

David Bienenfeld, MD  Professor of Psychiatry, Vice-Chair and Director of Residency Training, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Nothing to disclose.

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