Paraphilias are considered rare, affecting only a small percentage of the US population. Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. In some cases, individuals with paraphilias have the urges or fantasies, but do not act on them. People with paraphilias are generally unable to sustain an affectionate relationship and/or find it difficult. Most people with paraphilias are men, and many have more than one type of paraphilia. There is often an overlap of paraphilias, the most common being 2-3 concurrently present although cases of up to 10 have been reported in about 5% of paraphiliacs. Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilias. Some prescription medicines have been used to help decrease the compulsive thinking associated with the paraphilias. Cyproterone and medroxyprogesterone acetates are the two antiandrogens more commonly used. Long-acting gonadotropin-releasing hormone (GnRH) agonist analogues are the most potent antiandrogens, and selectively abolish testosterone secretion in a totally reversible fashion.
Causes of Paraphilias
Common Causes and Risk factors of Paraphilias
- Childhood trauma.
- Early emotional trauma.
Signs and Symptoms of Paraphilias
Common Sign and Symptoms of Paraphilias
- Panic attacks.
- Feelings of terror.
- Chest pain.
- Stomach problems.
Treatment for Paraphilias
Common Treatment for Paraphilias
- Antidepressant medications have been shown to reduce panic severity, eliminate attacks, and improve overall quality-of-life measures in patients with panic disorder. Monoamine oxidase inhibitors also are effective in the treatment of panic disorder.
- Benzodiazepines are as effective as antidepressants in reducing panic symptoms and frequency of attacks, are well tolerated, and have a short onset of action
- Imipramine and clomipramine are considered first-line treatment options for panic disorder.
- Fluoxetine (Prozac) can be used (especially if panic disorder occurs with depression); however, it may be poorly tolerated because it may initially increase anxiety, except at very low starting doses.
- Clonazepam (Klonopin) has become a favored replacement because it has a longer half-life and empirically elicits fewer withdrawal reactions upon discontinuation.