Clarke D J
Med Sci Law. 1989 Apr;29(2):136-46. doi: 10.1177/002580248902900209.
A minority of people with mental retardation have sexual behaviour which is socially unacceptable or which brings them into conflict with the law. Such behaviour may be the result of ignorance about sexual matters, often best managed by counselling or by a behavioural approach. There are a small number of men with mental retardation and aberrant sexual behaviour who benefit from the prescription of an antilibidinal drug. Treatment with an antilibidinal drug alone reduces the intensity of sexual drive but does not alter its direction; concurrent sexual counselling or psychotherapy is often indicated. The various antilibidinal medications available are reviewed, with particular attention to reports which have described the treatment of people with mental retardation. Of the antilibidinals currently used, medroxyprogesterone acetate and cyproterone acetate are those for which there is most evidence of efficacy. Cyproterone acetate is preferable because it has a specific antiandrogenic action and fewer adverse effects. There is a need for controlled studies of antilibidinal drugs, with clearly defined inclusion criteria and adequate measures of both behavioural and attitudinal change.
少数智力迟钝者存在社会无法接受或违法的性行为。此类行为可能是由于对性问题无知所致，通常通过咨询或行为疗法能得到最佳处理。有一小部分智力迟钝且性行为异常的男性从抗性欲药物的处方中获益。仅用抗性欲药物治疗可降低性欲强度，但不会改变其指向；通常还需要同时进行性咨询或心理治疗。本文综述了现有的各种抗性欲药物，尤其关注了有关智力迟钝者治疗的报道。在目前使用的抗性欲药物中，醋酸甲羟孕酮和醋酸环丙孕酮有最多的疗效证据。醋酸环丙孕酮更可取，因为它有特定的抗雄激素作用且副作用较少。需要进行抗性欲药物的对照研究，要有明确界定的纳入标准以及对行为和态度改变的充分测量方法。
