Bradford's comprehensive review on the role of serotonin in forensic psychiatry (J

We read with much interest Professor Bradford's comprehensive review on the role of serotonin in forensic psychiatry (J. M. W. Bradford, 24:57-72, 1996). He reviewed the literature on the treatment of primary paraphilias with selective serotonin reuptake inhibitors and the role of serotonin in disorders of sexuality. We would like to add [a note on] our experience with clozapine (a serotonin antagonist) in the treatment of comorbid sexual exhibition in schizophrenia. Most patients with sexual deviancy and schizophrenia have severe illnesses with prominent delusions and command hallucinations, which prove recalcitrant to conventional antipsychotic pharmacotherapy.' Consequently, these patients pose significant management problems and are often, in view of their real or perceived risk to the community, subject to protracted hospitalization and largely