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 importantand well known in the scientific debate about treatment ofparaphilic patients. In our first study of the treatment of paraphiliaswith luteinizing hormone-releasing hormone (LHRH)agonists, we showed that the effect of these agents, especiallyon paraphilic fantasies, remains questionable.¹ Nobody who isworking in the field would say that the risk of recidivism insexual offenders is abolished with medication. In our systematicreview of the treatment of paraphilia with LHRH agonists,²we proposed a treatment algorithm that includes the issuesDr. Saleh mentioned.’ ‹