Use of Depo-Provera to control sexual aggression in persons with traumatic brain injury

L. E. Emory, C. M. Cole, Walter Meyer

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To determine the effectiveness of medroxyprogesterone acetate (Depo-Provera) treatment in conjunction with psychological counseling on the hypersexual behavior seen in individuals with traumatic brain injury. Design: A retrospective review of the use of Depo-Provera in adult male patients who sustained a traumatic brain injury from blunt trauma and subsequently exhibited hypersexual behavior. All individuals were treated with a combination of weekly Depo-Provera injections and psychological counseling; the latter was educational/behavioral in nature and took into account such problems as deficits in awareness and empathy, poor memory, concreteness, and rigidity. Follow-up examinations were done every 3 months for at least 2 years and every 6 months thereafter. Setting: Individuals were seen in outpatient treatment and reside in community environments. Patients: Eight males (average age = 17.5 years at the time of head trauma) who developed problematic hypersexual behavior approximately 3 years later. These individuals were consecutive referrals to a psychiatric practice with expertise in the treatment of hypersexual behavior. Intervention: Weekly intramuscular Depo-Provera injections were used in conjunction with counseling. Main Outcome Measures: Incidence of hypersexual behavior; change in testosterone level. Results: In all cases, cessation of the unacceptable sexual behavior was noted while the men received treatment (mean duration = 42 months). Three individuals remain on Depo-Provera, and two have successfully discontinued treatment for 2 and 10 years, respectively, with no further problems. The remaining three reoffended when medication was discontinued, a decision made unilaterally by their families. Conclusions: The use of Depo-Provera in conjunction with counseling may offer an opportunity to control aberrant sexual behaviors after brain injury. However, only a minority of individuals stay in good control after discontinuing Depo-Provera.

Original languageEnglish (US)
Pages (from-to)47-58
Number of pages12
JournalJournal of Head Trauma Rehabilitation
Volume10
Issue number3
StatePublished - 1995

Fingerprint

Medroxyprogesterone Acetate
Aggression
Counseling
Sexual Behavior
Psychology
Therapeutics
Injections
Traumatic Brain Injury
Craniocerebral Trauma
Brain Injuries
Psychiatry
Testosterone
Outpatients
Referral and Consultation
Outcome Assessment (Health Care)
Incidence
Wounds and Injuries

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Health Professions(all)

Cite this

Use of Depo-Provera to control sexual aggression in persons with traumatic brain injury. / Emory, L. E.; Cole, C. M.; Meyer, Walter.

In: Journal of Head Trauma Rehabilitation, Vol. 10, No. 3, 1995, p. 47-58.

Research output: Contribution to journalArticle

Emory, L. E. ; Cole, C. M. ; Meyer, Walter. / Use of Depo-Provera to control sexual aggression in persons with traumatic brain injury. In: Journal of Head Trauma Rehabilitation. 1995 ; Vol. 10, No. 3. pp. 47-58.
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abstract = "Objective: To determine the effectiveness of medroxyprogesterone acetate (Depo-Provera) treatment in conjunction with psychological counseling on the hypersexual behavior seen in individuals with traumatic brain injury. Design: A retrospective review of the use of Depo-Provera in adult male patients who sustained a traumatic brain injury from blunt trauma and subsequently exhibited hypersexual behavior. All individuals were treated with a combination of weekly Depo-Provera injections and psychological counseling; the latter was educational/behavioral in nature and took into account such problems as deficits in awareness and empathy, poor memory, concreteness, and rigidity. Follow-up examinations were done every 3 months for at least 2 years and every 6 months thereafter. Setting: Individuals were seen in outpatient treatment and reside in community environments. Patients: Eight males (average age = 17.5 years at the time of head trauma) who developed problematic hypersexual behavior approximately 3 years later. These individuals were consecutive referrals to a psychiatric practice with expertise in the treatment of hypersexual behavior. Intervention: Weekly intramuscular Depo-Provera injections were used in conjunction with counseling. Main Outcome Measures: Incidence of hypersexual behavior; change in testosterone level. Results: In all cases, cessation of the unacceptable sexual behavior was noted while the men received treatment (mean duration = 42 months). Three individuals remain on Depo-Provera, and two have successfully discontinued treatment for 2 and 10 years, respectively, with no further problems. The remaining three reoffended when medication was discontinued, a decision made unilaterally by their families. Conclusions: The use of Depo-Provera in conjunction with counseling may offer an opportunity to control aberrant sexual behaviors after brain injury. However, only a minority of individuals stay in good control after discontinuing Depo-Provera.",
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