Inappropriate sexual behaviors in cognitively impaired older individuals

Conclusions: In general, unless the patient is engaging in or threatening dangerous acts involving physical contact, serotoninergics (first choice, SSRIs; second choice, TCAs) are first-line agents followed by antiandrogens (cyproterone acetate or medroxyprogesterone acetate) as second-line agents. LHRH agonists (first choice) and estrogens (second choice) are considered third-line agents. Combination therapy is reasonable if the patient fails to respond to monotherapy.