Zumpe D, Bonsall R W, Kutner M H, Michael R P
Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia 30306.
Horm Behav. 1991 Sep;25(3):394-409. doi: 10.1016/0018-506x(91)90010-f.
Medroxyprogesterone acetate (MPA) is used clinically to treat male sex offenders, but there are conflicting reports about its effects on aggression. To investigate these matters in a nonhuman primate, four intact male cynomolgus monkeys were studied in a testing paradigm that involved the presence of a caged, aggression-arousing stimulus male either immediately before or during a pair-test with an ovariectomized, untreated female partner. After two 4-week periods of pretreatment baseline, males received weekly injections of 40 mg MPA either alone (two 4-week treatment periods) or in combination with testosterone replacement with sc implants (one period) and additional daily injections of 2 mg testosterone propionate (two periods). MPA was then withdrawn while testosterone replacement continued (three periods). The testing paradigm was effective in maintaining aggression, especially male-male aggression, for many months. Male-male aggression increased with MPA treatment, and increased further with testosterone replacement, whereas male-female aggression tended to change in the opposite direction. As in earlier studies, MPA decreased both plasma testosterone and male sexual activity, but restoring plasma testosterone levels in treated males failed to restore their sexual activity. MPA therefore has behavioral effects that are not mediated primarily by its suppression of circulating androgens.
醋酸甲羟孕酮（MPA）在临床上用于治疗男性性犯罪者，但其对攻击性的影响存在相互矛盾的报道。为了在非人灵长类动物中研究这些问题，对四只完整的雄性食蟹猴进行了一项测试范式研究，该范式涉及在与去卵巢、未治疗的雌性伴侣进行配对测试之前或期间，放置一只关在笼子里、能激发攻击性的雄性刺激猴。在经过两个为期4周的预处理基线期后，雄性猴子每周单独注射40毫克MPA（两个为期4周的治疗期），或与皮下植入睾酮替代疗法联合使用（一个时期），并额外每日注射2毫克丙酸睾酮（两个时期）。然后停用MPA，继续进行睾酮替代疗法（三个时期）。该测试范式在数月内有效地维持了攻击性，尤其是雄性间的攻击性。雄性间的攻击性随着MPA治疗而增加，并随着睾酮替代疗法进一步增加，而雄性与雌性间的攻击性则倾向于朝相反方向变化。与早期研究一样，MPA降低了血浆睾酮水平和雄性性行为，但恢复治疗雄性的血浆睾酮水平未能恢复其性行为。因此，MPA的行为效应并非主要由其对循环雄激素的抑制作用介导。
