Gottesman H G, Schubert D S
Department of Psychiatry, MetroHealth Medical Center, Cleveland, OH 44109-1998.
J Clin Psychiatry. 1993 May;54(5):182-8.
There are no reports on the use of low-dose oral medroxyprogesterone acetate (MPA) in the treatment of the paraphilias. High-dose depot MPA treatment (500-800 mg i.m. weekly) has proven to control the behavioral manifestations of the paraphilias when testosterone levels decrease from pretreatment to prepubescent levels, but at the price of significant morbidity.
Oral MPA (60 mg/day for an average of 15.33 months) was given in an open nonblind trial to seven patients who met criteria for DSM-III-R paraphilias. Four of the subjects had shown inadequate improvement after 1 year of psychotherapy.
Six subjects responded at 60 mg/day. Testosterone levels decreased by 50% to 75% (range, 100-400 ng/dL). No patient displayed significant side effects. All patients described significantly fewer paraphilic fantasies, and no patient reported engaging in paraphilic behaviors during oral MPA treatment.
Double-blind placebo and phallometrically controlled tumescence studies need to be carried out to test the results of this study.
尚无关于低剂量口服醋酸甲羟孕酮（MPA）治疗性偏好障碍的报道。高剂量长效MPA治疗（每周肌肉注射500 - 800毫克）已被证明，当睾酮水平从治疗前降至青春期前水平时，可控制性偏好障碍的行为表现，但代价是出现明显的发病率。
在一项开放非盲试验中，对7名符合DSM - III - R性偏好障碍标准的患者给予口服MPA（60毫克/天，平均15.33个月）。其中4名受试者在接受1年心理治疗后改善不明显。
6名受试者在每天60毫克剂量时出现反应。睾酮水平下降了50%至75%（范围为100 - 400纳克/分升）。没有患者出现明显副作用。所有患者称恋物癖幻想显著减少，且在口服MPA治疗期间没有患者报告有恋物癖行为。
需要进行双盲安慰剂和阴茎体积描记法控制的勃起研究来验证本研究结果。
