Cooper A J
J Clin Psychiatry. 1987 Sep;48(9):368-70.
Four demented male patients who manifested disruptive sexual behavior, including public masturbation and attempts to molest female patients, and who could not be managed by other means received a therapeutic trial of medroxyprogesterone acetate (MPA) for 1 year and were followed up for an additional year. Their sexual activities were recorded before, during, and after the study, and serum testosterone, luteinizing hormone (LH), and prolactin were monitored regularly. Within 2 weeks of the start of MPA therapy, the sexual acting out had stopped; this was associated with a 90% and a 60% decline, respectively, of serum testosterone and LH. When MPA treatment was stopped, testosterone and LH returned to pretrial levels in all four men. One showed a return of sexual acting out, but this was at a reduced level and was successfully managed by firm nursing. MPA was used without adverse effects. Because of its safety and efficacy, the drug should be considered as a first-line treatment for sexual acting out in demented men.
四名患有痴呆症的男性患者表现出扰乱性行为，包括当众手淫和试图骚扰女性患者，且无法通过其他方式进行管理，他们接受了醋酸甲羟孕酮（MPA）为期1年的治疗试验，并额外随访了1年。在研究前、研究期间和研究后记录了他们的性活动，并定期监测血清睾酮、促黄体生成素（LH）和催乳素。在MPA治疗开始后的2周内，性冲动行为停止；这分别与血清睾酮和LH下降90%和60%相关。当停止MPA治疗时，所有四名男性的睾酮和LH都恢复到治疗前水平。其中一人出现了性冲动行为的复发，但程度有所减轻，并通过严格的护理成功控制。使用MPA没有不良反应。由于其安全性和有效性，该药物应被视为痴呆男性性冲动行为的一线治疗药物。
