inappropriate sexual behavior
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Etiology
- life-long sexual misbehavior
- dementia, especially Pick's disease
- psychiatric disorder
- dopamine agonists
- urinary tract infection (frequent manual manipulation of genitals)
History
- obtain history from staff & family
Laboratory
- prostate-specific antigen in serum
- luteinizing hormone in serum
- testosterone in serum
- urinalysis
- liver function tests
Management
- behavioral management first line (cognitive behavioral therapy)
- separation of victims from perpetrator
- pharmaceuticals (none FDA-approved for this purpose)
- cholinesterase inhibitors
- serotonin reuptake inhibitors
- sertraline 25-100 mg QD may reduce libido
- paroxetine (potential anticholinergic effect impacting cognitive function)
- mirtazapine may be useful if comorbidity of restless legs syndrome[2]
- clomipramine 25-100 mg QD if obsessive behavior
- cimetidine may be helpful
- antiandrogen compounds may also be helpful in men with sexual misbehavior
- progesterone start 5 mg PO QD
- leuprolide 5-10 mg IM monthly if behavior improves with progesterone
- progesterone start 5 mg PO QD
* see disinhibition for dosing
More general terms
Additional terms
References
- ↑ Annals of Long-Term Care
- ↑ Jump up to: 2.0 2.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022