Reply to "Issues to Consider in the Assement and Treatment of Paraphilic Patients"

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Sir: The 4 issues Dr. Saleh mentioned in his letter are important and well known in the scientific debate about treatment of paraphilic patients. In our first study of the treatment of paraphilias with luteinizing hormone–releasing hormone (LHRH) agonists, we showed that the effect of these agents, especially on paraphilic fantasies, remains questionable.1 Nobody who is working in the field would say that the risk of recidivism in sexual offenders is abolished with medication. In our systematic review of the treatment of paraphilia with LHRH agonists,2 we proposed a treatment algorithm that includes the issues Dr. Saleh mentioned.​

J Clin Psychiatry 2005;66(6):803-803