The role of antidepressants in treating sex offenders

The management of sex offenders is one of the biggest challenges today in the field of mental health. In France, the main tool used is still psychotherapy, sometimes associated with chemical castration. However, some medical teams have been trying to find pharmacological alternatives to libido reducing drugs, such as antidepressants. Objective. - We carried out a review of the literature in order to confirm partial efficacy of this class of pharmaceutical when used on sex offenders. Methodology. - We conducted our bibliographic research using the Medline search-engine, with keywords "antidepressants", "treatment", "paraphilia", "compulsive sexual behaviour", "sexual assault" and "sexual offenders". Results. - Serotonergic antidepressants (SRIs) have been prescribed with varying levels of success for this indication. However, the results are most conclusive in cases of sexual compulsions, and remain poor, not to say non-existent for paraphilias. Libido reducing drugs are still therefore the treatment of reference in these cases. Antidepressants are an interesting alternative where chemical castration is contraindicated, or in cases of sexual disorders with a strong element of compulsive behaviour. (C) 2011 Elsevier Masson SAS. All rights reserved.