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首页> 外文期刊>The journal of clinical psychiatry >Naltrexone in the treatment of adolescent sexual offenders.
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Naltrexone in the treatment of adolescent sexual offenders.

机译：纳曲酮治疗青少年性犯罪者。

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BACKGROUND: Naltrexone is a long-acting opioid used clinically in alcoholism, drug abuse, bulimia nervosa, obsessive-compulsive disorder, and impulse-control disorders. This study investigated whether naltrexone can decrease sexual arousal in legally adjudicated adolescent sexual offenders. METHOD: In an open-ended prospective study, naltrexone was given to 21 adolescents participating in an inpatient adolescent sexual offenders program who met any of the self-reported criteria of (1) masturbating 3 or more times per day, (2) feeling unable to control arousal, (3) spending more than 30% of awake time in sexual fantasies, or (4) having sexual fantasies or behavior that regularly intruded into and interfered with their functioning in the treatment program. After having been treated for more than 2 months, 13 patients had their naltrexone administratively stopped, thus providing a before, during, after, and resumption-of-treatment design. Behavioral changes were monitored daily with a fantasy-tracking logand a masturbation log. A positive result was recorded if there was more than a 30% decrease in any self-reported criterion that was applicable to each specific patient and this benefit lasted at least 4 months. Data were collected from July 2000 to December 2002. Leuprolide was given if naltrexone was not sufficiently helpful in controlling sexual impulses and arousal. RESULTS: Fifteen of 21 patients were considered to have a positive result and continued to respond for at least 4 months to an average dose of 160 mg per day with decreased sexual fantasies and masturbation. Dosages above 200 mg per day were not more helpful. Administrative discontinuation of naltrexone in a subset of 13 patients resulted in reoccurrence of symptoms that began when the dose taper reached 50 mg per day. There were no changes in clinical chemistries. Five of 6 patients who did not benefit from naltrexone responded favorably to leuprolide. CONCLUSIONS: Naltrexone at dosages of 100 to 200 mg per day provides a safe first step in treating adolescent sexual offenders. It is possible that the benefits observed here will generalize to the larger population of non-socially deviant hypersexual patients or "sexual addicts."
机译：背景：纳曲酮是一种长效阿片类药物，在临床上用于酗酒，吸毒，神经性贪食症，强迫症和冲动控制障碍。这项研究调查了纳曲酮是否可以减少依法审判的青少年性犯罪者的性唤起。方法：在一项开放性的前瞻性研究中，纳曲酮被给予参加住院青少年性罪犯计划的21名青少年，这些青少年满足以下任何自我报告的标准：（1）每天手淫3次或以上，（2）感到无法自慰为了控制唤醒，（3）将超过30％的清醒时间花费在性幻想上，或（4）经常性干预或干扰性幻想在治疗程序中发挥作用的性幻想或行为。经过2个多月的治疗，有13例患者接受了纳曲酮的行政停药，从而提供了治疗前，治疗中，治疗后和恢复治疗的设计。每天用幻想跟踪记录和自慰记录监视行为变化。如果适用于每位特定患者的任何自我报告的标准降低了30％以上，并且持续至少4个月，则记录为阳性结果。收集了2000年7月至2002年12月的数据。如果纳曲酮在控制性冲动和唤醒方面没有足够的帮助，则给予Leuprolide。结果：21例患者中有15例被认为具有阳性结果，并且持续至少4个月对平均每日160 mg的反应，且性幻想和手淫减少。每天200毫克以上的剂量没有更多帮助。在13名患者的亚组中行政终止纳曲酮导致症状的复发，这种症状的复发始于剂量逐渐减少至每天50 mg。临床化学没有变化。 6例未从纳曲酮中获益的患者中有5例对亮丙瑞林反应良好。结论：纳曲酮的剂量为每天100至200 mg，是治疗青少年性犯罪者的安全的第一步。此处观察到的好处可能会推广到更多的非社会性变性患者或“性瘾者”。

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