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Commentary: Risk/Benefit Ratio of Androgen Deprivation Treatment for Sex Offenders

Dr. Berlin is Associate Professor, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD. Address correspondence to: Fred S. Berlin, MD, PhD, The Johns Hopkins University School of Medicine, 104 E. Biddle Street, Baltimore, MD 21202. E-mail: fredsberlinmd{at}comcast.net

Androgen deprivation treatment (ADT) significantly lowers testosterone. That, in turn, can decrease sexual drive, facilitating better self-control and lower recidivism rates among sexually disordered offenders. Potential side effects can include: decreases in bone density; development of a metabolic syndrome involving weight gain, accompanied by changes in glucose and lipid metabolism; and rarely, depression. In the presence of a proper treatment protocol designed either to prevent or to minimize side effects, particularly the development of osteoporosis, the risks associated with ADT are generally within the same range as those associated with many other commonly prescribed psychotropic interventions.