Depo provera treatment for sex offending behavior: an evaluation of outcome.
W. J. d. Meyer, C. Cole and E. Emory,
Bull. Amer. Acad. Psychiatry & the Law
20(3): 249-59, 1992.
Forty men, ages 16 to 78 years, with sex-offending behavior, were treated with combined
medroxyprogesterone acetate (MPA), group therapy, and individual psychotherapy. Twenty-three
are pedophiles; seven, rapists; and 10, exhibitionists. Five had sex-offending behavior that began
after head trauma. The duration of MPA therapy, usual intramuscular dose 400 mg/wk, ranged from
six months to 12 years, usually more than two years. These men were compared with a control group
of 21 men who refused MPA therapy. They had similar types of sex-offending behavior and were
treated with psychotherapy alone with follow-up for a period that ranged from two to 12 years.
MPA-related side effects included excessive weight gain, malaise, migraine headaches, severe leg
cramps, elevation of blood pressure, gastrointestinal complaints, gallbladder stones, and diabetes
mellitus. Of the 40 individuals who took MPA, 10 are still on therapy. Eighteen percent reoffended
while receiving MPA therapy; 35 percent reoffended after stopping MPA. In contrast, 58 percent of
the control patients, who refused and never received MPA, reoffended. Patients defined as regressed
were much more likely to reoffend off therapy than the patients defined as fixated. Other risk factors
for reoffense include elevated baseline testosterone, previous head injury, never forming a marriage
relationship, and alcohol and drug abuse. In spite of significant medical side effects, maintenance
MPA offers benefit for the compulsive sex offender by reducing the reoffense rate.