What is the dosing for Depo-Provera (medroxyprogesterone acetate) for libido reduction in males with intellectual disability and paraphilic disorders?

From the Guidelines

For males with intellectual disability and sexual deviance requiring libido reduction, Depo-Provera (medroxyprogesterone acetate) is typically administered at a dose of 300-400 mg intramuscularly every 1-3 months, with 400 mg weekly for the first month sometimes used as an initial loading dose. This dosing regimen is based on the need to balance the reduction of libido with the potential side effects of the medication, such as weight gain, fatigue, and increased risk of cardiovascular issues 1. It is essential to initiate treatment under psychiatric supervision with informed consent from the patient or legal guardian. Regular monitoring is crucial, including liver function tests, blood glucose levels, and blood pressure checks. The medication works by reducing testosterone levels, thereby decreasing sexual urges and behaviors. It should be part of a comprehensive treatment plan that includes behavioral therapy and psychological support. Treatment duration varies based on individual response and should be periodically reassessed. Alternative medications like GnRH agonists (leuprolide) may be considered if Depo-Provera is ineffective or poorly tolerated.

Some key points to consider when using Depo-Provera for libido reduction in males with intellectual disability and sexual deviance include:

• The importance of regular monitoring to minimize potential side effects
• The need for a comprehensive treatment plan that includes behavioral therapy and psychological support
• The potential for alternative medications if Depo-Provera is ineffective or poorly tolerated
• The importance of initiating treatment under psychiatric supervision with informed consent from the patient or legal guardian

It is also important to note that the use of Depo-Provera for libido reduction in males with intellectual disability and sexual deviance is not explicitly mentioned in the provided evidence, and the dosing regimen mentioned is based on general knowledge of the medication's use for this purpose. However, the provided evidence does discuss the use of Depo-Provera for contraception and menstrual regulation, and highlights the importance of careful consideration of the potential benefits and risks of the medication 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Both the 1 mL vial and the 1 mL prefilled syringe of Medroxyprogesterone Acetate Injectable Suspension, USP should be vigorously shaken just before use to ensure that the dose being administered represents a uniform suspension The recommended dose is 150 mg of Medroxyprogesterone Acetate Injectable Suspension, USP every 3 months (13 weeks) administered by deep, IM injection in the gluteal or deltoid muscle The FDA drug label does not answer the question.

From the Research

Dosing for Depo Provera in Males with Intellectual Disability and Sexual Deviance

The dosing for Depo Provera (medroxyprogesterone acetate) in males with intellectual disability and sexual deviance is not explicitly stated in the provided studies. However, the following points can be noted:

• Medroxyprogesterone acetate is one of the antilibidinal medications used to reduce sexual drive in individuals with intellectual disability and aberrant sexual behavior 2, 3, 4.
• The use of medroxyprogesterone acetate has been reported in several case studies and reviews, but there is a need for controlled studies with clearly defined inclusion criteria and adequate measures of behavioral and attitudinal change 2, 4.
• The dosage and administration of medroxyprogesterone acetate may vary depending on the individual case and the specific treatment goals.

Key Considerations

Some key considerations when using antilibidinal medications like medroxyprogesterone acetate in males with intellectual disability and sexual deviance include:

• The need for concurrent sexual counseling or psychotherapy to address underlying issues and promote positive behavioral change 2, 3.
• The importance of informed consent and ethical considerations in the treatment of individuals with intellectual disability 3, 4.
• The potential for side effects and the need for ongoing monitoring and evaluation of treatment efficacy and safety 4.

Alternative Treatments

Other treatments that may be considered for males with intellectual disability and sexual deviance include:

• Cognitive-behavioral therapy (CBT) 5.
• Antiandrogen medications like cyproterone acetate, which may have a more specific mechanism of action and fewer adverse effects than medroxyprogesterone acetate 2, 4.