The management of sexual offending is a major challenge, particularly in men who have an intellectual disability. Psychological therapies have been shown beneficial, and programmes designed for use in the general population have been adapted for use in offenders who have an intellectual disability. There is also a role for pharmacological management, although the quality of evidence for this is noticeably lacking, most likely associated with the ethical and legal issues encountered in conducting well designed and controlled trials in this area. The purpose of this paper is to look at the pharmacological management options available.
A literature search of electronic databases was undertaken. Additionally, the references lists for identified papers were examined for any further relevant publications.
The two main categories of drugs used in the management of inappropriate sexual behaviour are the testosterone-lowering drugs and the psychotropic drugs. Most trials were open and utilised self-report measures of drug effectiveness, limiting their usefulness. Most trials noted beneficial effect. Side effect profiles and patient adherence can limit the effectiveness of anti-libidinal medication in practice.
There is very limited evidence available for the use of pharmacological agents in the management of inappropriate sexual behaviour, owing to the lack of adequately controlled clinical trials. New studies are therefore required, particularly of larger sample sizes, longer durations, and examining characteristics of those who benefit from pharmacological treatment, although the ethical issues of conducting such studies is duly acknowledged.
Sloan, S. and Brewster, E. (2017), "A review of the pharmacological management of sexually offending behaviour in learning disabled offenders", Journal of Intellectual Disabilities and Offending Behaviour, Vol. 8 No. 4, pp. 166-175. https://doi.org/10.1108/JIDOB-06-2017-0010
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