Monday, February 20, 2012

Topic: Medications with Sexual Side Effects

Medications and Medical Conditions
with Sexual Side Effects :

The intent here is NOT to attempt to justify sex crimes as being caused by a medication or medical condition, but to identify medications and medical conditions with sexual side effects. i.e., Hypersexuality
(Hypersexuality is one of the things that can ruin a bipolar person's marriage or committed relationship. In these days where sexually transmitted diseases can kill, unrestrained hypersexuality can also be deadly. Not every person who has bipolar disorder experiences this, but for those who do, it may be a serious problem. Finding the right combination of bipolar medications to control mania is an essential step toward keeping hypersexuality from becoming destructive.)
Hopefully lawyers will do their homework when they have clients charged with sex crimes and see if there is or isn't a medication or medical condition that may relate to the crime their client is charged with, and explore its relation before pleading a case out.

.... MORE COMING ....

In closing, the more I research these issues the more I see that, the law needs to look beyond criminal intent before criminally punishing a person for actions, some of which may be normal such as a Romeo & Juliet case, there may be other ways beyond punishment more helpful to society and the people involved. Just me thinking out loud...

Research & Papers about these Relationships:

Martin Paul Kafka (born 1947) is an American psychiatrist best known for his work on sex offenders, paraphilias and what he calls "paraphilia-related disorders" such as sex addiction and hypersexuality. See section on Selected publications

.... MORE COMING ....

Comments to News & Other Articles about these Relationships:

This related comment, reprinted w/permission, was in response to a article proposing separate nursing homes for sex offenders:
Another comment on this: When I was a "patient sitter" in a hospital some years ago, I discovered that brain-injured or delirious men can be sexually inappropriate--I had to call for help when one left his room and tried to get into bed with the patient in the next room (but that might not have been sexual--just disorientaton); a couple made sexual suggestions to me, which didn't bother me because I knew they were not responsible and since they were bedridden I was certainly in no danger; one tried to get me to masturbate him (I moved my chair so I was out of reach), and one called me his "sweet fat little pig," and I have no idea whether he was referring to a prostitute or a barbeque. He, and at least one of the others, were perfect gentlemen once their critical medical conditions came under control. Our daughter, who worked in a nursing home, has similar stories.

Also, I understand that when Washington State passed a law to put sex offenders in a separate nursing facility, and then could not get anyone to bid on providing such, the rape case they used as rationale for the law was perpetrated by a 90-year-old who was NOT a registered offender and died before any legal action could be taken. Keeping registered offenders out of nursing homes won't keep other patients from behaving in the way ill or demented persons do sometimes behave. Every nursing home should have protocols for dealing with such patients and staff trained to prevent problems, and I suspect that most do.

News & Other Articles Mentioning these Relationships:

Child sex offender attacked by victim's relatives 2-19-2012 Australia:

.... Justice Blow said Mr Martin, who was diagnosed with Parkinson's disease in 2005, would not have committed the crimes if he had not taken drugs prescribed for his condition, the dopamine agonists cabergoline and pramipexole. He said neurological reports showed the drugs had resulted in episodes of compulsive eating, buying, hoarding, hypersexuality and "punding", a fascination with pointless repetitive tasks.

The behaviour included using 162 different prostitutes at a cost of around $150,000. Justice Blow said Mr Martin's impulse control disorders were serious enough to be considered a mental illness. "Since ceasing the dopamine agonist medication in November 2009, Mr Martin has completely lost interest in pornography," Justice Blow said.

"He no longer experiences hypersexuality in any respect.
He has no sexual interest in children. He never did have a particular sexual interest in children, but was indiscriminate in the pornography that he obtained, and in the pornography that he used in creating his slide shows."

Justice Blow said Mr Martin had since suffered dopamine agonist withdrawal syndrome, which had symptoms of severe anxiety, and he was unable to work. ....

Autism and Sex Offenses:

A tailored approach for autistic youth?

High-functioning teens with autism may be difficult to spot because they don't display typical behaviors, such as rocking and hand waving, and their language skills may be adequate. Because the features of autism are less obvious among these youth, a disproportionate number land in juvenile detention for behaviors such as obsessive following or touching others, says school psychologist Tammy L. Hughes, PhD, who chairs Duquesne University's department of counseling, psychology and special education.

But the nature of their developmental disorder makes it imperative that they be treated in a way that recognizes their unique issues, preferably through well-designed diversion programs, she says.

"Not many young people with autism commit crimes, but of that small group, their needs are distinct," she says.

The issue came to Hughes's attention when her colleague Lawrence Sutton, PhD, a clinical psychologist who works for the state of Pennsylvania, observed that 43 percent of the young people in a juvenile sex-offense unit met criteria for autism. After taking a closer look, the psychologists also found that these young people weren't improving under traditional treatment approaches for sexual offenses. For example, the standard treatment for juvenile sex offenders places a strong emphasis on learning to empathize with the victim's point of view, as well as on putting young people into group formats that aid their socialization.

"But kids with autism have a lot of difficulty understanding another's perspective," Hughes says. Many also find traditional group therapy confusing and therefore ineffective.

Their motives are also different from those of typical sex-offending youth, says Hughes. For instance, they may come up to someone and smell and touch their shiny hair because of sensory-stimulation needs combined with poor social skills, "not because they're lying in wait to commit an assault," she says.

Several efforts are under way to address the courts' and public's lack of knowledge on this issue. Hughes and Sutton are working to set up screening and treatment mechanisms for youth who are already in detention. They have also developed a diagnostic protocol to help courts determine the treatment needs of high-functioning children with autism, as well as prevention and intervention programs to help these young people understand sexual development, peer relationships and dating. In addition, Hughes and others are training juvenile justice workers to appropriately assess and intervene with autistic youth.

"We'd like to have a system in place where we can catch problems in these young people early on and solve them," Hughes says, "and if we have to go before a judge, the judge is already informed about their needs."

—T. DeAng

Asperger's Disorder and Sex Offenses:

Asperger's Disorder and Criminal Behavior: Forensic-Psychiatric Considerations

Asperger's Disorder remains an under-diagnosed condition because of clinical unfamiliarity with its adult presentation. As forensic clinicians become familiar with the presentation of Asperger's disorder, it appears that affected individuals are over-represented in forensic criminal settings. Unique features of such persons may heighten their risks for engaging in criminal behavior. Both Theory of Mind deficits and a predilection for intense narrow interests, when coupled with deficient social awareness of salient interpersonal and social constraints on behavior, can result in criminal acts. We discuss comorbidities of forensic relevance. We present several cases that highlight these issues and review the relevant forensic literature. Furthermore, there may be valid questions as to degree of criminal responsibility in such persons. From a neuropsychiatric perspective, these disorders appear to have a biological underpinning for deficits in empathy, a finding that may have important repercussions when assessing remorse in criminal proceedings.

Because the DSM did not include Asperger's Disorder (AD) until the publication of its fourth edition in 1994 (DSM-IV),1 many forensic clinicians were not formally trained in diagnosing this condition in adults. As forensic mental health professionals become familiar with the features of AD and other high-functioning Autism Spectrum Disorders, they often realize that they have affected persons in their caseloads, but lack a diagnostic paradigm to subsume the clinical features with which they were presented. In this article, for diagnosis we relied on the most recent version of the Diagnostic and Statistical Manual, DSM-IV-TR (Table 1).2 The DSM-IV-TR refers to Asperger's Disorder as a developmental disorder that encompasses significant impairment across several domains (Table 1). However, other well-accepted diagnostic alternatives to DSM-IV-TR exist (Table 2).3,4 In this article, we will focus on Asperger's Disorder and the related higher functioning condition of Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and will refer to them as higher functioning Autism Spectrum Disorders (hfASDs).

Asperger's and Violence: Experts Weigh In

Dec. 19, 2012 -- Reports that Newtown shooter Adam Lanza had Asperger’s syndrome, a highly functioning form of autism, have led some to wonder whether that diagnosis could have played a role in the mass shooting, which killed 20 children and six adults at a Connecticut elementary school last week.

As with many cases such as this, the answer is complex. While experts are clear that Asperger's doesn’t make a person more likely to commit a violent crime, some say it may affect the way a crime is carried out.

Advocates for people with autism are more direct.

“Autism did not cause this crime,” says Peter Bell, MBA, executive vice president for programs and services at the nonprofit group Autism Speaks.

Bell, who also has a son with autism, says it’s important to understand that the condition is a developmental disorder that arises early in life. Children and adults with autism spectrum disorders struggle to communicate with others. They may feel socially isolated and have trouble feeling like part of a group. They may also have repetitive or restrictive behaviors, like rocking or shaking their hands.

“There’s absolutely nothing in that definition that talks about violence or committing aggressive acts,” Bell says.

Asperger’s and Violence


Articles mentioning violent behavior and medical conditions:

Thinking the Unthinkable

"That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn’t have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.

We still don’t know what’s wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work. ..."

For now, have a great day and a better tomorrow.
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