Evaluation of selective-serotonin reuptake inhibitors and anti-androgens to manage sexual compulsivity in individuals serving a custodial sentence for a sexual offence

Belinda Winder, Christine Norman, Jackie Hamilton, Steven Cass, Alex Lambert, Laura Tovey, Kerensa Hocken, Emma Marshall, Rebecca Lievesley, Laura Hamilton, Zoe Antoniadis, Adarsh Kaul

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Abstract

The UK prison system offers a medical treatment pathway for people suffering from problematic sexual arousal (PSA) who have committed a sexual offence(s). The two main medications are Anti-androgens (AAs) and Selective-Serotonin Reuptake Inhibitors (SSRIs). Currently, evidence of the effectiveness of SSRIs is not sufficiently robust for them to be licensed in the UK for that purpose. Instead, SSRIs are prescribed ‘off-label’, and physicians must adhere to additional obligations in prescribing them. Yet SSRIs have fewer side effects than AAs and may be a better treatment option for many patients. The present study examined the effectiveness of AAs and SSRIs in incarcerated individuals with PSA (n = 77); the unmedicated comparison group (n = 58) resided at the same prison which houses people convicted of a sexual offence. Both medicated groups demonstrated reduced levels of PSA 3 months post-baseline; the comparison group did not. The findings provide evidence for the effectiveness of SSRIs in reducing PSA. The authors argue a randomised control trial is required to underpin the use of SSRIs in treating PSA and (potentially) its subsequent licensing. The latter would enable wider prescription in prison and community and make a substantive contribution to the prevention of sexual abuse.
Original languageEnglish
Pages (from-to)1-36
Number of pages36
JournalThe Journal of Forensic Psychiatry & Psychology
Early online date16 Apr 2024
DOIs
Publication statusPublished online - 16 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Anti-libidinal
  • medication to manage sexual arousal
  • selective-serotonin reuptake inhibitors
  • anti-androgens
  • problematic sexual arousal
  • sexual offending

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